Provider Demographics
NPI:1831809037
Name:GIEBELSTEIN, GABRIELLE (QDA)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:GIEBELSTEIN
Suffix:
Gender:F
Credentials:QDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3332 WESTWOOD DR NW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52405-1349
Mailing Address - Country:US
Mailing Address - Phone:319-640-8408
Mailing Address - Fax:
Practice Address - Street 1:400 S CLINTON ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-4105
Practice Address - Country:US
Practice Address - Phone:319-358-4824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAQDA-14735126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant