Provider Demographics
NPI:1932601655
Name:WEAVER, EMILY GISPERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:GISPERT
Last Name:WEAVER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:EMILY
Other - Middle Name:GISPERT
Other - Last Name:WEAVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EMILY ANNE GISPERT
Mailing Address - Street 1:189 CHRISTIANA RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-3039
Mailing Address - Country:US
Mailing Address - Phone:302-322-2303
Mailing Address - Fax:
Practice Address - Street 1:189 CHRISTIANA RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-3039
Practice Address - Country:US
Practice Address - Phone:302-322-2303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-08
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-00014521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice