Healthcare Provider Details

I. General information

NPI: 1285804260
Provider Name (Legal Business Name): DR. GIAN PIETRO SCHINCAGLIA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2008
Last Update Date: 06/07/2022
Certification Date: 06/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 CHESTER AVE
CLEVELAND OH
44106-1666
US

IV. Provider business mailing address

9601 CHESTER AVE
CLEVELAND OH
44106-1666
US

V. Phone/Fax

Practice location:
  • Phone: 216-368-4412
  • Fax:
Mailing address:
  • Phone: 216-368-4422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number4206
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number30.026686
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: