Provider Demographics
NPI:1275820136
Name:BATCHELOR, GINA LOUISE (RDH)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:LOUISE
Last Name:BATCHELOR
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 64TH PL
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-5623
Mailing Address - Country:US
Mailing Address - Phone:909-286-1959
Mailing Address - Fax:
Practice Address - Street 1:15 64TH PL
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-5623
Practice Address - Country:US
Practice Address - Phone:909-286-1959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22562124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist