Peter Roland Degallier, DENTAL THERAPIST

Primary specialty

Dental TherapistTaxonomy code 125J00000X

License

DT117 Issued in MN

Practice address

720 E Highway 61
Winona, MN 55987-5300

Phone

(507) 452-9453

NPI assigned

Nov 13, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• River Hills Dental

  • General Practice Dentistry
  • Winona, MN
  • NPI 1497784342
  NPD (past)

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1124663109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 E HIGHWAY 61",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559875300",
            "telephone_number": "507-452-9453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 E HIGHWAY 61",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559875300",
            "telephone_number": "507-452-9453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGALLIER",
        "first_name": "PETER",
        "middle_name": "ROLAND",
        "credential": "DENTAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-13",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "125J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Therapist",
            "state": "MN",
            "license": "DT117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1497784342",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1992930556",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1801957758",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "riverhillsdental@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Secure Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "720 E Highway 61",
            "city": "Winona",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559875300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Matthew Lavern Debner, DDS
• Mikayla Deforrest
• Jaran Defries
• Hannah Degallier, PA-C
• Paul Degallier, DDS
• Christianne Danielle Del Castillo
• Ashley Delaurentis
• Bryan Delvin, LP
• Courtney E Dembiec, DDS
• Dale G Dennis, DC

• Dental Therapist in Winona, MN
• Providers in Winona, MN by specialty
• Dental Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; 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.