Provider Demographics
NPI:1508351990
Name:CASAREZ-QUINTANA, GIANNA NICOLE (DDS)
Entity type:Individual
Prefix:DR
First Name:GIANNA
Middle Name:NICOLE
Last Name:CASAREZ-QUINTANA
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 1:331 SPORTSPLEX DR STE B
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-5350
Mailing Address - Country:US
Mailing Address - Phone:512-858-7200
Mailing Address - Fax:
Practice Address - Street 1:331 SPORTSPLEX DR STE B
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-5350
Practice Address - Country:US
Practice Address - Phone:512-858-7200
Practice Address - Fax:512-858-7220
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD50901223G0001X
TXETN530390200000X
TXD374561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program