Provider Demographics
NPI:1598012478
Name:GIARDINO, MICHAEL A (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:GIARDINO
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 1:1305 NE 43RD ST
Mailing Address - Street 2:104
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-5815
Mailing Address - Country:US
Mailing Address - Phone:509-280-6250
Mailing Address - Fax:
Practice Address - Street 1:1305 NE 43RD ST
Practice Address - Street 2:104
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-5815
Practice Address - Country:US
Practice Address - Phone:509-280-6250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60305177122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist