Individual provider Active NPI

Michael Gillogly, D.D.S.

  • Dentist
  • Magnolia, TX
National Provider Identifier
1295927770
Registry record updated Aug 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
23506 Issued in TX
Practice address
6606 FM 1488 Rd Ste 136
Magnolia, TX 77354-2545
Phone
(936) 273-9399
NPI assigned
Aug 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 23506 TX Primary

Addresses

Primary practice location

6606 FM 1488 Rd Ste 136
Magnolia, TX 77354-2545

Mailing address

395 Sawdust Rd
PMB 2075
Spring, TX 77380-2242
Phone (210) 831-7394

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20161021000641 TX Order and Referring Only - DentistPractitioner - Dentist 5294013561

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23506TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Network Provider Associates, P.C. Dentist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187308800000",
    "number": "1295927770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 SAWDUST RD",
            "address_2": "PMB 2075",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773802242",
            "telephone_number": "210-831-7394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6606 FM 1488 RD STE 136",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773542545",
            "telephone_number": "936-273-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLOGLY",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-17",
        "last_updated": "2007-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "23506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Magnolia, TX

Sources for this page

Verify at the official NPI Registry.