Provider Demographics
NPI:1750145249
Name:GHALY, CHRISTINA (DMD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:GHALY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10416 NE 185TH ST APT 305
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-3030
Mailing Address - Country:US
Mailing Address - Phone:514-473-5453
Mailing Address - Fax:
Practice Address - Street 1:10830 19TH AVE SE STE A
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-5181
Practice Address - Country:US
Practice Address - Phone:514-473-5453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-06
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WA61687198122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program