Provider Demographics
NPI:1427056274
Name:HEYN, GAIL HINRICHS (DDS)
Entity type:Individual
Prefix:DR
First Name:GAIL
Middle Name:HINRICHS
Last Name:HEYN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 ROYAL CIR
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-6459
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:645 ROYAL CIR
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-6459
Practice Address - Country:US
Practice Address - Phone:814-234-0137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS035955122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019756400006Medicaid
PA0019756400005Medicaid
PA0019756400007Medicaid
PA0019756400009Medicaid
PA01975640Medicaid
PA0019756400004Medicaid
PADS035955OtherDELTA DENTAL
PA0019756400008Medicaid