Active NPI
Shawn Michael Gallegos, D.D.S.
- Dentist
- Danville, CA
National Provider Identifier
1114141801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 47474
- Practice address
- 4018 Blackhawk Plaza Cir
Danville, CA 94506-4654 - Phone
- (925) 787-3674
- Fax
- (925) 736-9865
- NPI assigned
- Apr 12, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 47474 | CA | Primary |
Addresses
Primary practice location
4018 Blackhawk Plaza Cir
Danville, CA 94506-4654
Mailing address
508 Berrellesa St
Martinez, CA 94553-1506
Phone (925) 736-9860
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 |
|---|---|---|---|
| 47474 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275436800000",
"number": "1114141801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "508 BERRELLESA ST",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "945531506",
"telephone_number": "925-736-9860",
"fax_number": "925-736-9865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4018 BLACKHAWK PLAZA CIR",
"city": "DANVILLE",
"state": "CA",
"postal_code": "945064654",
"telephone_number": "925-787-3674",
"fax_number": "925-736-9865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLEGOS",
"first_name": "SHAWN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-12",
"last_updated": "2010-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "47474",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Danville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.