Gallo Michels Professional Dental Corp

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

31040 Issued in CA

Legal business name

GALLO MICHELS PROFESSIONAL DENTAL CORP

Practice address

10645 Tierrasanta Blvd
Suite B
San Diego, CA 92124-2614

Phone

(858) 277-6080

Fax

(858) 277-4773

NPI assigned

Sep 7, 2006

Organization subpart

No

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

Authorized official

Name

Nicole Reid

Title

Regional Manager

Phone

(619) 261-1670

Specialties & licenses 1

Addresses

Other names 1

• Tierra Town Dental Doing business as

Tax ID family

Gallo Michels Professional Dental Corp3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Gallo Michels Professional Dental Corp

  • General Practice Dentistry
  • La Mesa, CA
  • NPI 1447352810
  NPD tax ID
• Gallo-Michles Professional Dental Corp.

  • General Practice Dentistry
  • Fresno, CA
  • NPI 1699111682
  NPD tax ID

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386747913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10645 TIERRASANTA BLVD",
            "address_2": "SUITE B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921242614",
            "telephone_number": "858-277-6080",
            "fax_number": "858-277-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10645 TIERRASANTA BLVD",
            "address_2": "SUITE B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921242614",
            "telephone_number": "858-277-6080",
            "fax_number": "858-277-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALLO MICHELS PROFESSIONAL DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "619-261-1670"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "31040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tierra Town Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erin Ann Gallent, M.D., PH.D.
• Megan Galligan, BCBA, PHD
• Kriston Gallipeau
• Tara Gallison, BCABA
• Gallo Michels Koryurek Prof Dental Corp
• Andrea Gallo Palafox, RN
• Ana-Maria Gallo
• Christopher Gallo, PA
• Dominic Gallo
• Mekenze Elizabeth Gallo

• General Practice Dentistry in San Diego, CA
• Providers in San Diego, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.