Provider Demographics
NPI:1013131259
Name:MEINECKE, GIGI (DMD)
Entity Type:Individual
Prefix:DR
First Name:GIGI
Middle Name:
Last Name:MEINECKE
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 1:10520 MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3837
Mailing Address - Country:US
Mailing Address - Phone:301-299-2925
Mailing Address - Fax:
Practice Address - Street 1:10520 MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-3837
Practice Address - Country:US
Practice Address - Phone:301-299-2925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10950122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist