Provider Demographics
NPI:1134293186
Name:GINGRICH, ROBERT SAMUEL (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:SAMUEL
Last Name:GINGRICH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8724 TUSCARORA PIKE
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25403-1012
Mailing Address - Country:US
Mailing Address - Phone:304-263-5432
Mailing Address - Fax:304-263-5432
Practice Address - Street 1:8724 TUSCARORA PIKE
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25403-1012
Practice Address - Country:US
Practice Address - Phone:304-263-5432
Practice Address - Fax:304-263-5432
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2797122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist