Individual provider Active NPI

Galina Miciu-Nicolaevici, DDS

  • General Practice Dentistry
  • Los Gatos, CA
National Provider Identifier
1114671658
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS106586 Issued in CA
Practice address
14475 S Bascom Ave
Los Gatos, CA 95032-2002
Phone
(408) 214-0913
NPI assigned
Feb 3, 2022
Last updated
Jan 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DDS106586 CA Primary

Addresses

Primary practice location

14475 S Bascom Ave
Los Gatos, CA 95032-2002

Mailing address

1608 W Campbell Ave # 197
Campbell, CA 95008-1535
Phone (408) 214-0913

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

LicenseStateTypeSpecialty
DDS106586CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Galina Miciu-Nicolaevici, DDS, Inc. General Practice CurrentSince Dec 17, 2023 Accepting new patients
Stella Kim DDS, Inc. General Practice PastSince Feb 1, 2022 Accepting new patients

Locations

1608 W Campbell Ave
Campbell, CA 95008
Phone (530) 873-4543

14475 S Bascom Ave
Los Gatos, CA 95032
Phone (408) 214-0913

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1643846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1114671658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 W CAMPBELL AVE # 197",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950081535",
            "telephone_number": "408-214-0913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14475 S BASCOM AVE",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322002",
            "telephone_number": "408-214-0913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICIU-NICOLAEVICI",
        "first_name": "GALINA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-03",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS106586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; 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.