Provider Demographics
NPI:1033497409
Name:GINOYA, KETAN G (DMD)
Entity Type:Individual
Prefix:
First Name:KETAN
Middle Name:G
Last Name:GINOYA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13901 COASTAL HWY STE 4
Mailing Address - Street 2:
Mailing Address - City:OCEAN CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21842-4476
Mailing Address - Country:US
Mailing Address - Phone:410-250-1559
Mailing Address - Fax:
Practice Address - Street 1:13901 COASTAL HWY STE 4
Practice Address - Street 2:
Practice Address - City:OCEAN CITY
Practice Address - State:MD
Practice Address - Zip Code:21842-4476
Practice Address - Country:US
Practice Address - Phone:410-250-1559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0148591223G0001X
MADN18558141223G0001X
MD161791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice