Active NPI
Dora Elena Gallego
- Dentist
- Poway, CA
National Provider Identifier
1164660379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 57930
- Practice address
- 12336 Meadowbrook LN
Poway, CA 92064-3508 - Phone
- (201) 919-3164
- NPI assigned
- Jan 26, 2009
- Sex
- Female
- 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 | 57930 | CA | Primary |
Addresses
Primary practice location
12336 Meadowbrook LN
Poway, CA 92064-3508
Mailing address
12336 Meadowbrook LN
Poway, CA 92064-3508
Phone (201) 919-3164
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 |
|---|---|---|---|
| 57930 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dora Elena Gallego DDS a Professional Dental Corporation | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Dental Clinic/Center
- Poway, CA
- NPI 1356936173
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232928000000",
"number": "1164660379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12336 MEADOWBROOK LN",
"city": "POWAY",
"state": "CA",
"postal_code": "920643508",
"telephone_number": "201-919-3164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12336 MEADOWBROOK LN",
"city": "POWAY",
"state": "CA",
"postal_code": "920643508",
"telephone_number": "201-919-3164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLEGO",
"first_name": "DORA",
"middle_name": "ELENA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-26",
"last_updated": "2009-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "57930",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poway, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.