Provider Demographics
NPI:1427108307
Name:GVILDYS, RAMA EMILIJA (DMD)
Entity type:Individual
Prefix:DR
First Name:RAMA
Middle Name:EMILIJA
Last Name:GVILDYS
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 1:399B OXFORD LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-1729
Mailing Address - Country:US
Mailing Address - Phone:551-404-5769
Mailing Address - Fax:
Practice Address - Street 1:1961 MORRIS AVE
Practice Address - Street 2:SUITE A-1
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-3531
Practice Address - Country:US
Practice Address - Phone:551-404-5769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI018202011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6516408Medicaid