Anthony Ronald Gambla, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11485 Issued in IL

Practice address

4301 W 95TH St
Oak Lawn, IL 60453-2670

Phone

(708) 423-0014

Fax

(708) 423-0453

NPI assigned

May 22, 2007

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326257882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532670",
            "telephone_number": "708-423-0014",
            "fax_number": "708-423-0453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532670",
            "telephone_number": "708-423-0014",
            "fax_number": "708-423-0453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLA",
        "first_name": "ANTHONY",
        "middle_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "11485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniela Rose Galassini
• Mirela Galatanu, MD
• Julia M Galemb, M.S., OTR/L
• Tracey Gallatin, PT
• Kelly A Gallo
• Jason Thomas Gambla
• Andres J Gamboa, DPT
• Paula Patricia Gamero Kubota, MD
• Nishita Gandhi
• Shailesh Gandhi, MD

• General Practice Dentistry in Oak Lawn, IL
• Providers in Oak Lawn, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.