Active NPI
Agnes Barbagallo, DDS
- Pediatric Dentistry
- Goshen, NY
National Provider Identifier
1033464607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 056455
- Practice address
- 5 Hatfield LN Ste 3
Goshen, NY 10924-6756 - Phone
- (845) 360-5883
- NPI assigned
- Jul 19, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DN19670 | FL | |
| Pediatric Dentistry | 1223P0221X | 22DI02520200 | NJ | |
| Pediatric Dentistry | 1223P0221X | 056455 | NY | Primary |
Addresses
Primary practice location
5 Hatfield LN Ste 3
Goshen, NY 10924-6756
Mailing address
5 Hatfield LN Ste 3
Goshen, NY 10924-6756
Phone (845) 360-5883
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056455 | NY | MD | Clinical Social Worker |
| DN19670 | FL | MD | Pediatric Dentist |
| 22DI02520200 | NJ | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704931200000",
"number": "1033464607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 HATFIELD LN STE 3",
"city": "GOSHEN",
"state": "NY",
"postal_code": "109246756",
"telephone_number": "845-360-5883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 HATFIELD LN STE 3",
"city": "GOSHEN",
"state": "NY",
"postal_code": "109246756",
"telephone_number": "845-360-5883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARBAGALLO",
"first_name": "AGNES",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-19",
"last_updated": "2024-01-11",
"certification_date": "2024-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "FL",
"license": "DN19670",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NJ",
"license": "22DI02520200",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NY",
"license": "056455",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goshen, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.