Diego Alberto Gallardo

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

3315 Issued in PR

Practice address

Suite 201, Guaynabo Radiology & Medical Plaza
10 Ave Las Cumbres
Guaynabo, PR 00969

Phone

(787) 233-7267

NPI assigned

Jul 19, 2011

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/7274/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dr Diego Gallardo Torres-Aguiar PSC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Vega Alta, PR
  • NPI 1043843055
  Medicare reassignment NPD
• Proms LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Guaynabo, PR
  • NPI 1871272740
  NPD
• Coviello Oral Surgery PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Falls Church, VA
  • NPI 1326388992
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1003104464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "D2 CALLE 2 ALT. DE SANS SOUCI",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00957",
            "telephone_number": "787-243-0269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SUITE 201, GUAYNABO RADIOLOGY & MEDICAL PLAZA",
            "address_2": "10 AVE LAS CUMBRES",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00969",
            "telephone_number": "787-233-7267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLARDO",
        "first_name": "DIEGO",
        "middle_name": "ALBERTO",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-19",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401415980",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PR",
            "license": "3315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edgardo Gago Sanabria, 0829P
• Ricardo Galan
• Jose L Galarza, M.D., M.P.H.
• Galeria Quiropractica PSC
• Maria De Los Angeles Gallardo-Gonzalez, MA, MS, BCBA
• Yolanda Galloza Echevarria, 1263P
• Gamuzza Inc of PR Corporation
• Elba Maria Garcia - Quintana
• Itxa Garcia Antorgiorgi, 1003P
• Rafael Garcia Barcena, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Guaynabo, PR
• Providers in Guaynabo, PR by specialty
• Oral and Maxillofacial Surgery (Dentist) in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.