Provider Demographics
NPI:1952926123
Name:CHRISTA J. GARCIA, DDS PLLC
Entity type:Organization
Organization Name:CHRISTA J. GARCIA, DDS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:SHEARS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-265-2438
Mailing Address - Street 1:122 YATES AVE
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:WV
Mailing Address - Zip Code:26354-1611
Mailing Address - Country:US
Mailing Address - Phone:304-265-2438
Mailing Address - Fax:304-265-2438
Practice Address - Street 1:25 BARBARA ST
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:WV
Practice Address - Zip Code:26354-8116
Practice Address - Country:US
Practice Address - Phone:304-265-2438
Practice Address - Fax:304-265-2438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-12
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1811419674Medicaid
WV1811419674Medicaid