Provider Demographics
NPI:1760776553
Name:BUFALINI, GINA ROSE (DMD)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:ROSE
Last Name:BUFALINI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BAYARD RD
Mailing Address - Street 2:UNIT 116
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-1955
Mailing Address - Country:US
Mailing Address - Phone:412-877-3608
Mailing Address - Fax:
Practice Address - Street 1:101 DRAKE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1556
Practice Address - Country:US
Practice Address - Phone:412-831-3373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS038399122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist