Nazareth Bedoya Gallego

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

107286 Issued in CA

Practice address

12321 Oak Knoll Rd
Poway, CA 92064-5319

Phone

(201) 919-8061

NPI assigned

Feb 28, 2022

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Dora Elena Gallego DDS a Professional Dental Corporation

  • Dental Clinic/Center
  • Poway, CA
  • NPI 1356936173
  NPD

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

{
    "created_epoch": "1646006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1447906458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12321 OAK KNOLL RD",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920645319",
            "telephone_number": "201-919-8061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12321 OAK KNOLL RD",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920645319",
            "telephone_number": "201-919-8061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDOYA GALLEGO",
        "first_name": "NAZARETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-28",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zoey Battle
• Peter Jeffrey Bauer, DDS, MS
• Ohara Bautista
• Nayeli Becerril
• Michelle Becker, LMFT
• Santiago Bedoya Gallego, DDS
• Jessica Megan Behne, LMFT
• Amy Lynn Belanger, LMFT
• Tyrone Belcher
• Mary Louise Belgira

• General Practice Dentistry in Poway, CA
• Providers in Poway, 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 Apr 26, 2024; 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.