Provider Demographics
NPI:1225761869
Name:INGALLS, EMILY CODY (DMD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:CODY
Last Name:INGALLS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6812 ARBOR OAKS DR
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-7401
Mailing Address - Country:US
Mailing Address - Phone:757-810-9138
Mailing Address - Fax:
Practice Address - Street 1:3565 53RD AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-3489
Practice Address - Country:US
Practice Address - Phone:941-758-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN27145122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist