Provider Demographics
NPI:1538203096
Name:GIRGIS, GEHAN R (DDS)
Entity type:Individual
Prefix:DR
First Name:GEHAN
Middle Name:R
Last Name:GIRGIS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 W AVON RD
Mailing Address - Street 2:SUITE 19
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-2759
Mailing Address - Country:US
Mailing Address - Phone:248-650-2440
Mailing Address - Fax:248-650-8922
Practice Address - Street 1:930 W AVON RD STE 19
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-2759
Practice Address - Country:US
Practice Address - Phone:248-650-2440
Practice Address - Fax:248-650-4370
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-17
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010158381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice