Provider Demographics
NPI:1841428117
Name:GAIRHAN, EMILY (DDS)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:GAIRHAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:BALLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3113 ANNADALE CV
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-9504
Mailing Address - Country:US
Mailing Address - Phone:870-219-1552
Mailing Address - Fax:
Practice Address - Street 1:3113 ANNADALE CV.
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72404-9515
Practice Address - Country:US
Practice Address - Phone:870-219-1552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR37091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice