Provider Demographics
NPI:1154405819
Name:BACHICHA, CHRISTINA MARIA (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:MARIA
Last Name:BACHICHA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 ENCINO PL NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-2602
Mailing Address - Country:US
Mailing Address - Phone:505-243-6714
Mailing Address - Fax:505-243-6746
Practice Address - Street 1:606 ENCINO PL NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2602
Practice Address - Country:US
Practice Address - Phone:505-243-6714
Practice Address - Fax:505-243-6746
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD19381223G0001X
AZD49591223G0001X
NE63031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice