Individual provider Active NPI

Obed Rabsaris Galla Pimentel, DDS

  • Dentist
  • Kalamazoo, MI
National Provider Identifier
1629799515
Registry record updated Feb 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901601633 Issued in MI
Practice address
5017 W Main St
Kalamazoo, MI 49009-1001
Phone
(269) 350-2146
NPI assigned
Sep 8, 2022
Last updated
Feb 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12013931A IN
Dentist 122300000X 109998 CA
Dentist 122300000X 2901601633 MI Primary

Addresses

Primary practice location

5017 W Main St
Kalamazoo, MI 49009-1001

Mailing address

8707 Meadowlark LN
Berrien Springs, MI 49103-1450
Phone (269) 235-4753

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12013931AINMDDentist
2901601633MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mashini Dental Group PLLC PastSince Apr 1, 2023 Accepting new patients

Organizations & group practices 2

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": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738972800000",
    "number": "1629799515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8707 MEADOWLARK LN",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491031450",
            "telephone_number": "269-235-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5017 W MAIN ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490091001",
            "telephone_number": "269-350-2146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLA PIMENTEL",
        "first_name": "OBED",
        "middle_name": "RABSARIS",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-08",
        "last_updated": "2025-02-08",
        "certification_date": "2025-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12013931A",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "109998",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901601633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2025; 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.