Gregory N Borganelli DMD PA

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN12271 Issued in FL

Legal business name

GREGORY N BORGANELLI DMD PA

Practice address

875 SW State Rd 47
Lake City, FL 32025

Phone

(386) 752-8200

Fax

(386) 752-8209

NPI assigned

Dec 3, 2007

Last updated

Dec 3, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gregory N Borganelli, DMD PA

Title

President of Corporation

Phone

(386) 752-8200

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1184806010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 SW STATE RD 47",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "32025",
            "telephone_number": "386-752-8200",
            "fax_number": "386-752-8209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 SW STATE RD 47",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "32025",
            "telephone_number": "386-752-8200",
            "fax_number": "386-752-8209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY N BORGANELLI DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-03",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "BORGANELLI",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "386-752-8200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD PA"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN12271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanna Green, APRN
• Sparkle Green, ARNP
• Todd Green, PTA
• Virgiree Green
• Meagan Greenwood
• Debra K Griffin, AU.D.
• Rachel Groves, APRN
• Jamie Lynn Grubb, L.M.T.
• Matthew Thomas Grubb, L.M.T.
• Rachel McClellan Grubb, M.A. CCC-SLP

• Pediatric Dentistry in Lake City, FL
• Providers in Lake City, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; 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.