Provider Demographics
NPI:1467510537
Name:BIGELOW, GILBERT ULYSSES (DDS)
Entity Type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:ULYSSES
Last Name:BIGELOW
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 1:1812 OLYMPIC DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-3721
Mailing Address - Country:US
Mailing Address - Phone:757-427-0673
Mailing Address - Fax:
Practice Address - Street 1:1812 OLYMPIC DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23453-3721
Practice Address - Country:US
Practice Address - Phone:757-427-0673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010081391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice