Healthcare Provider Details

I. General information

NPI: 1346810801
Provider Name (Legal Business Name): MEGHAN BRIANNE GAITENS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3112 LITTLE RD
TRINITY FL
34655-1864
US

IV. Provider business mailing address

152 PARK TRACE BLVD
OSPREY FL
34229-8899
US

V. Phone/Fax

Practice location:
  • Phone: 941-313-4560
  • Fax:
Mailing address:
  • Phone: 941-313-4560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDGD.9926
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number13626
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN25878
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDGD.9926
License Number StateSC
# 5
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN25878
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number25878
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: