William James Gallo, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

008828 Issued in MI

Practice address

322 Bay St
Petoskey, MI 49770-2489

Phone

(231) 347-1601

Fax

(231) 347-0330

NPI assigned

Nov 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1174507495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 BAY ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702489",
            "telephone_number": "231-347-1601",
            "fax_number": "231-347-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 BAY ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702489",
            "telephone_number": "231-347-1601",
            "fax_number": "231-347-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLO",
        "first_name": "WILLIAM",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "008828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FACILITY",
            "identifier": "1154483014",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GROUP ID",
            "identifier": "0B46032",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "WG008828",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathan David Fry, DMD
• Gary Lee Fuchs, MD
• Katie Fulcher
• Fyzical Therapy and Balance Center by the Bay
• Gerald A. Gadowski, DO
• James Randall Galloway, DO
• Lisa Anne Galloway, D.O.
• Jazmin Garcia, LMSW
• Gary H. Shaw, M.D., P.C.
• Jocindee Gasco, MA, LLP, CAADC

• Oral and Maxillofacial Surgery (Dentist) in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.