Christine Renee' Mize, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

17662 Issued in TX

Practice address

101 Pine Manor Dr
Oak Ridge North, TX 77385-9059

Phone

(281) 364-7914

NPI assigned

Feb 8, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1043964026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 E BRACEBRIDGE CIR",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773822541",
            "telephone_number": "281-536-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PINE MANOR DR",
            "city": "OAK RIDGE NORTH",
            "state": "TX",
            "postal_code": "773859059",
            "telephone_number": "281-364-7914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZE",
        "first_name": "CHRISTINE",
        "middle_name": "RENEE'",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "17662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREE DENTAL CARE",
            "identifier": "17662",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://interfaithcommunityclinic.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "101 Pine Manor Dr",
            "city": "Oak Ridge North",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773859059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Gayle Stan
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• The Community Clinic

• Dentist in Oak Ridge North, TX
• Providers in Oak Ridge North, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.