Provider Demographics
NPI:1750397600
Name:GIGLIOTTI, MICHAEL CHARLES (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CHARLES
Last Name:GIGLIOTTI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7412 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15218-2521
Mailing Address - Country:US
Mailing Address - Phone:412-271-1020
Mailing Address - Fax:412-271-1021
Practice Address - Street 1:7412 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15218-2521
Practice Address - Country:US
Practice Address - Phone:412-271-1020
Practice Address - Fax:412-271-1021
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021502L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009073880003Medicaid