Individual provider Active NPI

Rodger A. Galloway, D.D.S.

  • General Practice Dentistry
  • North Bend, WA
National Provider Identifier
1265658983
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6825 Issued in WA
Practice address
227 W 2ND St
North Bend, WA 98045-8124
Phone
(425) 888-2330
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6825 WA Primary

Addresses

Primary practice location

227 W 2ND St
North Bend, WA 98045-8124

Mailing address

227 W 2ND St
P.O. Box 1355
North Bend, WA 98045-8124
Phone (425) 888-2330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20150803001043 WA Order and Referring Only - DentistPractitioner - Dentist 9638483795

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6825WAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265658983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 W 2ND ST",
            "address_2": "P.O. BOX 1355",
            "city": "NORTH BEND",
            "state": "WA",
            "postal_code": "980458124",
            "telephone_number": "425-888-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 W 2ND ST",
            "city": "NORTH BEND",
            "state": "WA",
            "postal_code": "980458124",
            "telephone_number": "425-888-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLOWAY",
        "first_name": "RODGER",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "6825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bend, WA

Sources for this page

Verify at the official NPI Registry.