Gallo Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

31040 Issued in MI

Legal business name

GALLO DENTAL CORPORATION

Practice address

5690 N Fresno St Ste 101
Fresno, CA 93710-8332

Phone

(559) 436-3470

Fax

(559) 436-3465

NPI assigned

Sep 23, 2007

Organization subpart

No

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

Authorized official

Name

Susan Nitta

Title

Office Administrator

Phone

(559) 436-3470

Specialties & licenses 1

Addresses

Other names 1

• Affinity Dental Doing business as

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

{
    "created_epoch": "1190505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190505600000",
    "number": "1386830347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5690 N FRESNO ST STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937108332",
            "telephone_number": "559-436-3470",
            "fax_number": "559-436-3465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5690 N FRESNO ST STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937108332",
            "telephone_number": "559-436-3470",
            "fax_number": "559-436-3465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALLO DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-23",
        "last_updated": "2007-09-23",
        "status": "A",
        "authorized_official_last_name": "NITTA",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "559-436-3470"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "31040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affinity Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseluis Jesus Gallegos
• Lizette Gallegos
• Priscilla Ann Gallegos, LVN
• Andrew James Galli
• Randi A Galli, M.D.
• Gallo-Michles Professional Dental Corp.
• Brenda Joy Gallo
• Samantha Jo Gallo, P.A.
• Jacqueline Gallot, PSYCHIATRIC TECH
• Yolanda Galloway

• General Practice Dentistry in Fresno, CA
• Providers in Fresno, 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 Sep 23, 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.