James Patrick Gagliardi, D.D.S.

Individual provider Active NPI General Practice Dentistry · Fircrest, WA

NPI 1043281165 · NPPES record last updated May 13, 2013

Key facts

NPI
1043281165
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DE00005122 (WA)
Practice address
1033 Regents Blvd
Suite 201
Fircrest, WA 98466-6045
Phone
(253) 564-2570
Fax
(253) 564-2652
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
DE00005122WAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE00005122 WA Yes

Addresses

Primary practice location

1033 Regents Blvd
Suite 201
Fircrest, WA 98466-6045

Mailing address

1033 Regents Blvd
Suite 201
Fircrest, WA 98466-6045
Phone (253) 564-2570

Other providers in Fircrest, WA

All providers in Fircrest, WA · General Practice Dentistry in Washington

Sources for this page

Verify at the official NPI Registry.