Healthcare Provider Details

I. General information

NPI: 1053747105
Provider Name (Legal Business Name): GIGI CAINES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2013
Last Update Date: 09/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 COMMANDANT GADE
ST. THOMAS VI
00802
US

IV. Provider business mailing address

2344 COMMANDANT GADE # 18OV
ST THOMAS VI
00802-5504
US

V. Phone/Fax

Practice location:
  • Phone: 340-776-3371
  • Fax:
Mailing address:
  • Phone: 340-776-3371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number1-7924-1L
License Number StateVI

VIII. Authorized Official

Name: GIGI CAINES
Title or Position: DENTIST/OWNER
Credential: DDS
Phone: 340-776-3371