Provider Demographics
NPI:1679633028
Name:INGALLINERA, DAVID GERARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:GERARD
Last Name:INGALLINERA
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 1:416 E OGDEN AVENUE
Mailing Address - Street 2:SUITE H
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559
Mailing Address - Country:US
Mailing Address - Phone:630-655-0240
Mailing Address - Fax:630-655-0253
Practice Address - Street 1:416 E OGDEN AVENUE
Practice Address - Street 2:SUITE H
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559
Practice Address - Country:US
Practice Address - Phone:630-655-0240
Practice Address - Fax:630-655-0253
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice