Gillian Ann Degennaro

Primary specialty

DentistTaxonomy code 122300000X

License

D011895 Issued in AZ

Practice address

781 S Cotton LN Ste 100
Goodyear, AZ 85338-4644

Phone

(440) 547-3162

NPI assigned

Apr 26, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688774400000",
    "number": "1831887124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 E DATE PALM PASEO APT 2217",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917644699",
            "telephone_number": "440-547-3162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 S COTTON LN STE 100",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853384644",
            "telephone_number": "440-547-3162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGENNARO",
        "first_name": "GILLIAN",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-26",
        "last_updated": "2023-07-08",
        "certification_date": "2023-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D011895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth Patricia De la Rosa-Acosta, BESTDOULACERTIFICATE
• Marvin Leandicho De Leon, LPN
• Deals Az LLC
• Dean Whiting DDS MSD PLLC
• Beth Payne Dean, PA-C
• Nicole Deglane Chavez, LAC
• Kelsey Deits
• Darla Jean Delamater-Burruel, RDH
• Celeste M Delap, DPT
• Andrea Deleon

• Dentist in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2023; 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.