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General NPI Number Information
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NPI Number | 1346810801
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Entity Type | Individual
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Provider Name | MEGHAN GAITENS DMD
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Gender | Female
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Dates
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Enumeration Date | 06/28/2021
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Last Update Date | 05/14/2024
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Provider Practice Location Address
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Address Line | 3980 WILSON RD
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City | MEBANE
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State | NC
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Zip | 27302-9985
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Country | US
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Telephone | 984-203-4021
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Fax |
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Provider Business Mailing Address
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Address Line | 152 PARK TRACE BLVD
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City | OSPREY
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State | FL
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Zip | 34229-8899
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Country | US
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Telephone | 941-313-4560
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DGD.9926
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DGD.9926
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 13626
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN25878
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 25878
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License Number State | FL
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