Gwen Giannina, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02051800 Issued in NJ

Practice address

1173 Kennedy Blvd
Bayonne, NJ 07002-3132

Phone

(201) 339-1177

Fax

(201) 339-2120

NPI assigned

Aug 2, 2005

Reactivated

Apr 2, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gwen Giannina DDS, LLC

  • Dentist
  • Bayonne, NJ
  • NPI 1174794275
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1376544205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1173 KENNEDY BLVD",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "07002",
            "telephone_number": "201-339-1177",
            "fax_number": "201-339-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1173 KENNEDY BLVD",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023132",
            "telephone_number": "201-339-1177",
            "fax_number": "201-339-2120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "345 E 24th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100104020",
            "country_code": "US",
            "telephone_number": "212-998-9800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "345 E 24th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100104020",
            "country_code": "US",
            "telephone_number": "212-998-9755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIANNINA",
        "first_name": "GWEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2013-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "057765",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "20518",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02051800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Alice Gerry
• Eric Gewolb, M.D.
• Maria Ghaly, PA-C
• Marelle Ghobryal, DC
• Silvya Ghoubrial
• Carla Giannobile, L.AC.
• Jagjit Kaur Gill
• Fulvia Giraldi, DPM
• Diana Girgis, APN
• Ibraam S Girgis, PHRAMACIST

• General Practice Dentistry in Bayonne, NJ
• Providers in Bayonne, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.