Provider Demographics
NPI:1053748764
Name:DAVID INGALLINERA, DDS,PC
Entity type:Organization
Organization Name:DAVID INGALLINERA, DDS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:INGALLINERA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-323-7303
Mailing Address - Street 1:211 W CHICAGO AVE
Mailing Address - Street 2:SUITE 216
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3355
Mailing Address - Country:US
Mailing Address - Phone:630-323-7303
Mailing Address - Fax:630-323-7783
Practice Address - Street 1:211 W CHICAGO AVE
Practice Address - Street 2:SUITE 216
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3355
Practice Address - Country:US
Practice Address - Phone:630-323-7303
Practice Address - Fax:630-323-7783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019025292122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty