Provider Demographics
NPI:1871101451
Name:SARMIENTO, CHRISTINE FRANCES (DMD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:FRANCES
Last Name:SARMIENTO
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 1:1729 N 1ST ST APT 20902
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-4635
Mailing Address - Country:US
Mailing Address - Phone:510-755-9720
Mailing Address - Fax:
Practice Address - Street 1:1155 N CAPITOL AVE STE 160
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95132-2500
Practice Address - Country:US
Practice Address - Phone:408-272-2720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104961122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist