Individual provider Active NPI

Lauren Gagliano, DDS

  • General Practice Dentistry
  • Anchorage, AK
National Provider Identifier
1417109265
Registry record updated Oct 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
936 Issued in AK
Practice address
4361 Boniface Pkwy
Anchorage, AK 99504-4316
Phone
(907) 333-1211
NPI assigned
Oct 10, 2008
Last updated
Oct 10, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 936 AK Primary

Addresses

Primary practice location

4361 Boniface Pkwy
Anchorage, AK 99504-4316

Mailing address

PO Box 210549
Anchorage, AK 99521-0549
Phone (907) 333-1211

Other identifiers 1

IdentifierTypeStateIssuer
DD0936MedicaidAK

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
I20160621001806 TX Order and Referring Only - DentistPractitioner - Dentist 7214228337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical Dental Center of Alaska Inc General Practice 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223596800000",
    "number": "1417109265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 210549",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995210549",
            "telephone_number": "907-333-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4361 BONIFACE PKWY",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995044316",
            "telephone_number": "907-333-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGLIANO",
        "first_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-10",
        "last_updated": "2008-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD0936",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.