Healthcare Provider Details

I. General information

NPI: 1487448676
Provider Name (Legal Business Name): JAKE DAVID GILARDI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2025
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

748 S NEW ST
DOVER DE
19904-3573
US

IV. Provider business mailing address

748 S NEW ST
DOVER DE
19904-3573
US

V. Phone/Fax

Practice location:
  • Phone: 302-734-8101
  • Fax:
Mailing address:
  • Phone: 302-734-8101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberG1-0011659
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: