Provider Demographics
NPI:1518949247
Name:O'BEIRNE, GERRARDA CONCEPTA (BDS,MSD)
Entity Type:Individual
Prefix:
First Name:GERRARDA
Middle Name:CONCEPTA
Last Name:O'BEIRNE
Suffix:
Gender:F
Credentials:BDS,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 OLIVE WAY
Mailing Address - Street 2:SUITE 810
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1878
Mailing Address - Country:US
Mailing Address - Phone:206-628-0404
Mailing Address - Fax:206-628-0024
Practice Address - Street 1:720 OLIVE WAY
Practice Address - Street 2:SUITE 810
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1878
Practice Address - Country:US
Practice Address - Phone:206-628-0404
Practice Address - Fax:206-628-0024
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA7333122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist