Bruce V Gallup, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

3223 Issued in ME

Practice address

211 Mount Auburn Ave
Auburn, ME 04210-8521

Phone

(207) 514-7171

Fax

(207) 514-7177

NPI assigned

May 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Central Maine Oral & Maxillofacial Surgery Associates, PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Auburn, ME
  • NPI 1982763801
  NPD (past)

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354147200000",
    "number": "1790788487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 MOUNT AUBURN AVE",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042108521",
            "telephone_number": "207-514-7171",
            "fax_number": "207-514-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 MOUNT AUBURN AVE",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042108521",
            "telephone_number": "207-514-7171",
            "fax_number": "207-514-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLUP",
        "first_name": "BRUCE",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2012-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "ME",
            "license": "3223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269850099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paige Frost, OD
• Danielle Claire Gagne, M.S., CCC-SLP
• Mary A Gagnon, LMFT
• Tyler J Gagnon, DMD
• Brian L Gallagher, DMD
• Avery Gamache, MS, OTR/L
• Mohamed Gamal-Eldin, MD
• David Gandelman, O.D
• Richard Blair Garini, ATC
• Alexandra Garry, LCPC

• Oral and Maxillofacial Surgery (Dentist) in Auburn, ME
• Providers in Auburn, ME by specialty
• Oral and Maxillofacial Surgery (Dentist) in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2012; 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.