Individual provider Active NPI

Edward Daniel Gall III, D.D.S.

  • Periodontics
  • Tucson, AZ
National Provider Identifier
1780679878
Registry record updated Sep 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
D7216 Issued in AZ
Practice address
2330 N Rosemont Blvd
Suite a
Tucson, AZ 85712-2163
Phone
(520) 327-0263
Fax
(520) 327-0965
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 1099689 TX
Periodontics 1223P0300X D7216 AZ Primary

Addresses

Primary practice location

2330 N Rosemont Blvd
Suite a
Tucson, AZ 85712-2163

Mailing address

12678 N Yellow Bird Rd
Oro Valley, AZ 85755-7415
Phone (520) 797-5568

Other names 1

  • Dr. E. Daniel Gall Other name

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
D7216AZMDPeriodontist
1099689TXMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Clyde M. Robinson D.D.S.,M.SC.D., P.C. Periodontics 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285545600000",
    "number": "1780679878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12678 N YELLOW BIRD RD",
            "city": "ORO VALLEY",
            "state": "AZ",
            "postal_code": "857557415",
            "telephone_number": "520-797-5568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 N ROSEMONT BLVD",
            "address_2": "SUITE A",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122163",
            "telephone_number": "520-327-0263",
            "fax_number": "520-327-0965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALL",
        "first_name": "EDWARD",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2010-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "1099689",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "D7216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "E.",
            "last_name": "GALL",
            "middle_name": "DANIEL",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; 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.