Healthcare Provider Details

I. General information

NPI: 1548266364
Provider Name (Legal Business Name): EUGENE T GIANNINI D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 04/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 WISCONSIN AVE NW STE 200
WASHINGTON DC
20016-4647
US

IV. Provider business mailing address

4801 WISCONSIN AVE NW STE 200
WASHINGTON DC
20016-4647
US

V. Phone/Fax

Practice location:
  • Phone: 202-244-4111
  • Fax: 202-244-6389
Mailing address:
  • Phone: 202-244-4111
  • Fax: 202-244-6389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN5141
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: