Provider Demographics
NPI:1417575713
Name:GINSKI, IGNATIUS PHILLIP (DDS)
Entity Type:Individual
Prefix:DR
First Name:IGNATIUS
Middle Name:PHILLIP
Last Name:GINSKI
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 1:4283 RALEIGH MILLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-2207
Mailing Address - Country:US
Mailing Address - Phone:901-633-1657
Mailing Address - Fax:
Practice Address - Street 1:4283 RALEIGH MILLINGTON RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-2207
Practice Address - Country:US
Practice Address - Phone:901-633-1657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-13
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN113801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice