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General NPI Number Information
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NPI Number | 1902765019
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Entity Type | Individual
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Provider Name | MIREYA GALVAN DMD
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Gender | Female
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Dates
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Enumeration Date | 01/15/2026
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 9501 171ST ST STE H-103
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City | TINLEY PARK
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State | IL
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Zip | 60487-6110
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Country | US
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Telephone | 708-580-6888
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Fax |
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Provider Business Mailing Address
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Address Line | 8625 S 79TH CT
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City | JUSTICE
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State | IL
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Zip | 60458-2327
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Country | US
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Telephone | 312-401-5336
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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 | 019036122
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License Number State | IL
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