Provider Demographics
NPI:1154553378
Name:CHIANG, KRISTI ANNE (DDS)
Entity type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:ANNE
Last Name:CHIANG
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 1:1720 W MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-1801
Mailing Address - Country:US
Mailing Address - Phone:714-535-4850
Mailing Address - Fax:714-535-0459
Practice Address - Street 1:1720 W MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1801
Practice Address - Country:US
Practice Address - Phone:714-535-4850
Practice Address - Fax:714-535-0459
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60335122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist