Individual provider Active NPI

Gary Clemente Gagliardi, DDS

  • General Practice Dentistry
  • Cherry Hill, NJ
National Provider Identifier
1437126331
Registry record updated Mar 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13578 Issued in NJ
Practice address
1878 Route 70 E
Suite 1
Cherry Hill, NJ 08003-2090
Phone
(856) 751-1352
Fax
(856) 751-6775
NPI assigned
Mar 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2009

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 13578 NJ Primary

Addresses

Primary practice location

1878 Route 70 E
Suite 1
Cherry Hill, NJ 08003-2090

Mailing address

1878 Route 70 E
Suite 1
Cherry Hill, NJ 08003-2090
Phone (856) 751-1352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20151204000844 NJ Order and Referring Only - DentistPractitioner - Dentist 7810297322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13578NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238112000000",
    "number": "1437126331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1878 ROUTE 70 E",
            "address_2": "SUITE 1",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032090",
            "telephone_number": "856-751-1352",
            "fax_number": "856-751-6775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1878 ROUTE 70 E",
            "address_2": "SUITE 1",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032090",
            "telephone_number": "856-751-1352",
            "fax_number": "856-751-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGLIARDI",
        "first_name": "GARY",
        "middle_name": "CLEMENTE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2009-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "13578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.