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General NPI Number Information
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NPI Number | 1467661371
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Entity Type | Individual
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Provider Name | MELISSA E GIERMAN DDS
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Gender | Female
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 06/19/2020
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Provider Practice Location Address
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Address Line | 430 S MAIN ST
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City | LOMBARD
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State | IL
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Zip | 60148-2600
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Country | US
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Telephone | 630-627-8601
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Fax | 630-627-0055
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Provider Business Mailing Address
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Address Line | 430 S. MAIN ST.
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City | LOMBARD
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State | IL
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Zip | 60148
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Country | US
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Telephone | 630-627-8601
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Fax | 630-627-0055
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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 | 019-025868
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License Number State | IL
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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 | 019.025868
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License Number State | IL
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