Individual ProviderChristopher ViravongsaDentistDental ProvidersPractice Address7101 W Craig Rd, Las Vegas, NV 89129-6058(702) 722-2324PECOS EnrollmentBased on the most recent information from CMS, provider Christopher Viravongsa does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1982056818Provider TypeIndividualFull NameViravongsa, ChristopherCredentialDMDGenderMaleSole ProprietorNoEnumeration Date7/3/2016Last Updated7/3/2016Contact InformationPractice LocationPractice Address7101 W Craig Rd, Las Vegas, NV 89129-6058Phone(702) 722-2324FaxUnlisted FaxMailing LocationMailing Address7101 W Craig Rd, Las Vegas, NV 89129-6058Phone(702) 722-2324FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode122300000XPrimaryDescriptionDentistDental ProvidersLicense6773Nevada