Provider Demographics
NPI:1689485906
Name:NEWELL, CHRISTINA R (RDH)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:R
Last Name:NEWELL
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 252
Mailing Address - Street 2:
Mailing Address - City:GOODMAN
Mailing Address - State:MO
Mailing Address - Zip Code:64843-0252
Mailing Address - Country:US
Mailing Address - Phone:417-592-1443
Mailing Address - Fax:
Practice Address - Street 1:927 N 71 BUSINESS HWY
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:MO
Practice Address - Zip Code:64831-9753
Practice Address - Country:US
Practice Address - Phone:417-355-9402
Practice Address - Fax:417-845-0094
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004013236124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist