Provider Demographics
NPI:1487867297
Name:MILLS, CHRISTINA MILLS
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:MILLS
Last Name:MILLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-5193
Mailing Address - Country:US
Mailing Address - Phone:703-846-9509
Mailing Address - Fax:703-845-9451
Practice Address - Street 1:1712 I ST NW STE 800
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-3740
Practice Address - Country:US
Practice Address - Phone:202-872-8200
Practice Address - Fax:202-785-4787
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN42301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice