Provider Demographics
NPI:1821009176
Name:SMIGA, INGRID IRENE (DMD)
Entity Type:Individual
Prefix:DR
First Name:INGRID
Middle Name:IRENE
Last Name:SMIGA
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 1:305 ABBEY BROOK LA
Mailing Address - Street 2:
Mailing Address - City:VENETIA
Mailing Address - State:PA
Mailing Address - Zip Code:15367
Mailing Address - Country:US
Mailing Address - Phone:724-518-3322
Mailing Address - Fax:
Practice Address - Street 1:ROUTE 19
Practice Address - Street 2:NORTHGATE PLAZA
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301
Practice Address - Country:US
Practice Address - Phone:724-223-0750
Practice Address - Fax:724-223-8761
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030713L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1019361710014Medicaid