Provider Demographics
NPI:1093150856
Name:IREGUI, CHIARINA M
Entity Type:Individual
Prefix:
First Name:CHIARINA
Middle Name:M
Last Name:IREGUI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 HOLLYCROFT ST
Mailing Address - Street 2:280W
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1305
Mailing Address - Country:US
Mailing Address - Phone:253-514-6076
Mailing Address - Fax:253-857-4119
Practice Address - Street 1:2727 HOLLYCROFT ST
Practice Address - Street 2:280W
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1305
Practice Address - Country:US
Practice Address - Phone:253-514-6076
Practice Address - Fax:253-857-4119
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60334827122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist