Provider Demographics
NPI:1497794341
Name:MIRANDA, GAYLE TUTONE (DDS)
Entity Type:Individual
Prefix:DR
First Name:GAYLE
Middle Name:TUTONE
Last Name:MIRANDA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MS
Other - First Name:GAIL
Other - Middle Name:
Other - Last Name:TUTONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:65 CENTRAL PARK W
Mailing Address - Street 2:APT 10G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-6007
Mailing Address - Country:US
Mailing Address - Phone:212-787-7584
Mailing Address - Fax:
Practice Address - Street 1:423 E 23RD ST
Practice Address - Street 2:DENTAL SERVICE 630/160
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5011
Practice Address - Country:US
Practice Address - Phone:212-951-3255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0418631223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery