Individual provider Active NPI

Peter Andrew Gadioli, D.D.S.

  • General Practice Dentistry
  • Richmond, MI
National Provider Identifier
1730484791
Registry record updated Jan 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901020327 Issued in MI
Practice address
36600 Heritage Dr
Richmond, MI 48062-1937
Phone
(586) 727-3815
NPI assigned
Jan 21, 2011
Last updated
Jan 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901020327 MI Primary

Addresses

Primary practice location

36600 Heritage Dr
Richmond, MI 48062-1937

Mailing address

15336 Yale Dr
Clinton Township, MI 48038-1098
Phone (586) 292-8989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20150708000386 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7618289489

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901020327MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Pradko, Gallagher & Slance, PLLC General Practice Past Accepting new patients

Organizations & group practices 1

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": "1295568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295568000000",
    "number": "1730484791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15336 YALE DR",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381098",
            "telephone_number": "586-292-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36600 HERITAGE DR",
            "city": "RICHMOND",
            "state": "MI",
            "postal_code": "480621937",
            "telephone_number": "586-727-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADIOLI",
        "first_name": "PETER",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-21",
        "last_updated": "2011-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, MI

Sources for this page

Verify at the official NPI Registry.