Provider Demographics
NPI:1245466481
Name:GIRARDOT, JAVIER (DMD)
Entity type:Individual
Prefix:
First Name:JAVIER
Middle Name:
Last Name:GIRARDOT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:ML 5018
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3039
Mailing Address - Country:US
Mailing Address - Phone:513-636-4315
Mailing Address - Fax:513-636-6567
Practice Address - Street 1:3333 BURNET
Practice Address - Street 2:ML 3016
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3039
Practice Address - Country:US
Practice Address - Phone:513-636-4588
Practice Address - Fax:513-636-0345
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN186841223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry