Provider Demographics
NPI:1902042666
Name:GARY W. MACHIKO, DMD, RPLLC
Entity Type:Organization
Organization Name:GARY W. MACHIKO, DMD, RPLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:W
Authorized Official - Last Name:MACHIKO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:412-367-1319
Mailing Address - Street 1:9380 MCKNIGHT RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237
Mailing Address - Country:US
Mailing Address - Phone:412-367-1319
Mailing Address - Fax:412-630-9267
Practice Address - Street 1:9380 MCKNIGHT RD
Practice Address - Street 2:SUITE 103
Practice Address - City:PGH
Practice Address - State:PA
Practice Address - Zip Code:15237
Practice Address - Country:US
Practice Address - Phone:412-367-1319
Practice Address - Fax:412-630-9267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-31
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-22945-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty