Brian Joseph Gambla, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019-022092 Issued in IL

Practice address

7350 W College Dr Ste 105
Palos Heights, IL 60463-1187

Phone

(708) 448-3323

Fax

(708) 448-3478

NPI assigned

Mar 8, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dental Associates, P.C.

  • General Practice Dentistry
  • Palos Heights, IL
  • NPI 1215146741
  NPD (past)
• Onik Family Dental, P.C.

  • Dentist
  • Palos Heights, IL
  • NPI 1457532202
  NPD (past)

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414368000000",
    "number": "1770614778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7350 W COLLEGE DR STE 105",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631187",
            "telephone_number": "708-448-3323",
            "fax_number": "708-448-3478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7350 W COLLEGE DR STE 105",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631187",
            "telephone_number": "708-448-3323",
            "fax_number": "708-448-3478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLA",
        "first_name": "BRIAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2014-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-022092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Marie Friel, SLP
• Henry J Fuentes, M.D.
• Karla Monique Funches, LPC
• Functional Skills Group
• Mary Elizabeth Gaeta, MSW
• Romal I Gandhi, MD
• Patrick J. Gannon, D.D.S.
• Lizhu Gao, M.D.
• David M Garagiola, M.D.
• Roxanna Melissa Garcia, M.D.

• General Practice Dentistry in Palos Heights, IL
• Providers in Palos Heights, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.