NPIMap

Organization Active NPI

Ganglani DMD PLLC

Doing business as Fresh Dental Gastonia

  • General Practice Dentistry
  • Gastonia, NC
National Provider Identifier
1093326555
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GANGLANI DMD PLLC
Doing business as
Fresh Dental Gastonia
Practice address
4008 E Franklin Blvd Ste 100
Gastonia, NC 28056-8537
Phone
(704) 816-0649
NPI assigned
Aug 10, 2020
Last updated
Aug 10, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
GANGLANI DMD PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Authorized official

Name
Richard B Velazque
Title
Directer of Implementation
Phone
(704) 218-2132

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

4008 E Franklin Blvd Ste 100
Gastonia, NC 28056-8537

Mailing address

4008 E Franklin Blvd Ste 100
Gastonia, NC 28056-8537
Phone (704) 816-0649

Other names 1

  • Fresh Dental Gastonia Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ganglani DMD PLLC9 organizations share this tax ID, including this one
Part of
Ganglani DMD PLLC

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4008 E Franklin Blvd
Ste 100
Gastonia, NC 28056
Phone (704) 816-0649

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597017600000",
    "number": "1093326555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4008 E FRANKLIN BLVD STE 100",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280568537",
            "telephone_number": "704-816-0649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4008 E FRANKLIN BLVD STE 100",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280568537",
            "telephone_number": "704-816-0649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GANGLANI DMD PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GANGLANI DMD PLLC",
        "enumeration_date": "2020-08-10",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A",
        "authorized_official_last_name": "VELAZQUE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DIRECTER OF IMPLEMENTATION",
        "authorized_official_telephone_number": "704-218-2132"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fresh Dental Gastonia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.