NPIMap

Organization Active NPI

Ganglani DMD PLLC

Doing business as FRESHDental Harrisburg

  • General Practice Dentistry
  • Harrisburg, NC
National Provider Identifier
1285301390
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GANGLANI DMD PLLC
Doing business as
FRESHDental Harrisburg
Practice address
4200 Main St Ste 103
Harrisburg, NC 28075-7491
Phone
(704) 516-0275
NPI assigned
Aug 26, 2021
Last updated
Aug 26, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
GANGLANI DMD PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Authorized official

Name
Richard B Velazque
Title
Director of Implementation
Phone
(704) 516-0275

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

4200 Main St Ste 103
Harrisburg, NC 28075-7491

Mailing address

3935 Somerdale LN Ste 110
Charlotte, NC 28205-4515
Phone (704) 516-0275

Other names 1

  • FRESHDental Harrisburg Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ganglani DMD PLLC9 organizations share this tax ID, including this one
Part of
Ganglani DMD PLLC

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4200 Main St
Ste 103
Harrisburg, NC 28075
Phone (704) 516-0275

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629936000000",
    "number": "1285301390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3935 SOMERDALE LN STE 110",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282054515",
            "telephone_number": "704-516-0275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 MAIN ST STE 103",
            "city": "HARRISBURG",
            "state": "NC",
            "postal_code": "280757491",
            "telephone_number": "704-516-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GANGLANI DMD PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GANGLANI DMD PLLC",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A",
        "authorized_official_last_name": "VELAZQUE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DIRECTOR OF IMPLEMENTATION",
        "authorized_official_telephone_number": "704-516-0275"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FRESHDental Harrisburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrisburg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.