Provider Demographics
NPI:1801498985
Name:UY, GINA (DMD)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:UY
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 1:450 DUNDEE AVE
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-4205
Mailing Address - Country:US
Mailing Address - Phone:844-599-3700
Mailing Address - Fax:
Practice Address - Street 1:450 DUNDEE AVE
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-4205
Practice Address - Country:US
Practice Address - Phone:844-599-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-12
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24332122300000X
IL019.033049122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist