Individual provider Active NPI

Douglas Allen Gilio, DDS

  • Periodontics
  • Visalia, CA
National Provider Identifier
1477580421
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
25092 Issued in CA
Practice address
1128 N Chinowth Street
Visalia, CA 93291-7896
Phone
(559) 625-4915
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 25092 CA Primary

Addresses

Primary practice location

1128 N Chinowth Street
Visalia, CA 93291-7896

Mailing address

1128 N Chinowth St
Visalia, CA 93291-7896
Phone (559) 625-4915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150715002567 CA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 5890008114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25092CAMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477580421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1128 N CHINOWTH ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932917896",
            "telephone_number": "559-625-4915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 N CHINOWTH STREET",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932917896",
            "telephone_number": "559-625-4915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILIO",
        "first_name": "DOUGLAS",
        "middle_name": "ALLEN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "25092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.