Active NPI
Obed Rabsaris Galla Pimentel, DDS
- Dentist
- Kalamazoo, MI
National Provider Identifier
1629799515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901601633
- Practice address
- 5017 W Main St
Kalamazoo, MI 49009-1001 - Phone
- (269) 350-2146
- NPI assigned
- Sep 8, 2022
- Last updated
- Feb 8, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 12013931A | IN | MD | Dentist |
| 2901601633 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mashini Dental Group PLLC | Past | 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.
-
- General Practice Dentistry
- Kalamazoo, MI
- NPI 1750102281
-
- General Practice Dentistry
- Benton Harbor, MI
- NPI 1972095032
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.