MEDICARE: GINO ANTHONY ORLANDI DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	19606	TX

General Provider Information

NPI Number	:	1306870209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINO ANTHONY ORLANDI DDS

Provider Business Mailing Address
First Line	:	5123 SPRING ASH
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78247-1827
Country	:	US
Telephone Number	:	210-967-4982
Fax Number	:

Provider Business Practice Location Address
First Line	:	2407 S CONGRESS AVE
Second Line	:	SUITE A100
City	:	AUSTIN
State	:	TX
Zip	:	78704-5505
Country	:	US
Telephone Number	:	512-326-3003
Fax Number	:	512-326-4128

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	03/13/2012

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