Marguerite Angela Barbagallo, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

460 Coventry LN
Suite 202
Crystal Lake, IL 60014-7561

Phone

(815) 459-3100

Fax

(815) 459-6794

NPI assigned

Nov 6, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245319698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 COVENTRY LN",
            "address_2": "SUITE 202",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147561",
            "telephone_number": "815-459-3100",
            "fax_number": "815-459-6794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 COVENTRY LN",
            "address_2": "SUITE 202",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147561",
            "telephone_number": "815-459-3100",
            "fax_number": "815-459-6794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARBAGALLO",
        "first_name": "MARGUERITE",
        "middle_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Bandel
• Hailee Bane, RBT
• Moriah Bang, D.O.
• Farhan J Bangash, DO
• Debra Baran, LCPC, CADC
• Randi Y Barbon, RN, CDE
• Jonathan Paul P. Barbosa
• Sarah Jane Barham
• Angelica Barnes, LPC
• Kevin Franklin Barnes, A.T.C./L.

• General Practice Dentistry in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.