Individual provider Active NPI

Liboria McDonald Gallant, RDH

  • Dental Hygienist
  • Apo Ae, NY
National Provider Identifier
1679676712
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH005929 Issued in GA
Practice address
Unit 26610
Wuerzburg Dental Activity Credentials Office
Apoae, NY 09244
Phone
(931) 804-3933
NPI assigned
Sep 6, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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
Dental Hygienist 124Q00000X DH005929 GA Primary

Addresses

Primary practice location

Unit 26610
Wuerzburg Dental Activity Credentials Office
Apoae, NY 09244

Mailing address

Unit 26610
Wuerzburg Dental Activity Credentials Office
Apoae, NY 09244
Phone (931) 804-3933

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
DH005929GAMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679676712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIT 26610",
            "address_2": "WUERZBURG DENTAL ACTIVITY CREDENTIALS OFFICE",
            "city": "APOAE",
            "state": "NY",
            "postal_code": "09244",
            "telephone_number": "931-804-3933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIT 26610",
            "address_2": "WUERZBURG DENTAL ACTIVITY CREDENTIALS OFFICE",
            "city": "APOAE",
            "state": "NY",
            "postal_code": "09244",
            "telephone_number": "931-804-3933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLANT",
        "first_name": "LIBORIA",
        "middle_name": "MCDONALD",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "GA",
            "license": "DH005929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apo Ae, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.