John Matthew Gallucci, D.M.D., B.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D9304 Issued in OR

Practice address

1017 Molalla Ave
Suite 1
Oregon City, OR 97045-3772

Phone

(503) 657-7770

Fax

(503) 657-9832

NPI assigned

Jul 20, 2009

Last updated

Jul 23, 2014By the provider in NPPES

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

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

Locations

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.

• John M Gallucci DMD PC

  dba Cascade Smiles

  • General Practice Dentistry
  • Oregon City, OR
  • NPI 1194125351
  NPD Authorized official
• Michelle R. Bloemers, DMD, LLC

  • Dental Clinic/Center
  • Oregon City, OR
  • NPI 1477311488
  NPD (past)

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

{
    "created_epoch": "1248048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406073600000",
    "number": "1437389913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 MOLALLA AVE",
            "address_2": "SUITE 1",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970453772",
            "telephone_number": "503-657-7770",
            "fax_number": "503-657-9832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 MOLALLA AVE",
            "address_2": "SUITE 1",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970453772",
            "telephone_number": "503-657-7770",
            "fax_number": "503-657-9832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLUCCI",
        "first_name": "JOHN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.M.D., B.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-20",
        "last_updated": "2014-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Furrer, LMT
• Gaffney Operations, LLC
• Lynn Marcum Gaffney, BSHCA, SSD, CHW
• Richard Galindo
• Katelin Gallion
• Timofey Sergeyevich Galuza, PSYD
• Jeffrey Steven Gander, RN
• Shannon Renea Gander, LMFT-INTERN
• Annette Gandy
• Victor Manuel Garcia del Castillo

• General Practice Dentistry in Oregon City, OR
• Providers in Oregon City, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.