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General NPI Number Information
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NPI Number | 1235064734
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Entity Type | Individual
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Provider Name | GABRIELLE SHAY KASARDA DDS
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Gender | Female
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Dates
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Enumeration Date | 06/16/2026
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Last Update Date | 06/16/2026
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Provider Practice Location Address
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Address Line | 3099 CENTRAL AVE
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City | LAKE STATION
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State | IN
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Zip | 46405-2207
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Country | US
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Telephone | 219-763-8112
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Fax |
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Provider Business Mailing Address
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Address Line | 9457 MONROE ST APT 1001
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City | CROWN POINT
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State | IN
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Zip | 46307-6246
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Country | US
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Telephone | 260-227-2581
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12015068A
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License Number State | IN
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