Organization Active NPI

DRS. Moser and Gallisdorfer,PA

  • General Practice Dentistry
  • Winston Salem, NC
National Provider Identifier
1861605172
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5143 Issued in NC
Legal business name
DRS. MOSER AND GALLISDORFER,PA
Practice address
116 Jonestown Rd
Winston Salem, NC 27104-4617
Phone
(336) 768-7495
Fax
(336) 768-7499
NPI assigned
May 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jeffrey Gallisdorfer, DDSNPI 1922026632
Title
Dentist-Partner
Phone
(336) 768-7495

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 5143 NC Primary

Addresses

Primary practice location

116 Jonestown Rd
Winston Salem, NC 27104-4617

Mailing address

116 Jonestown Rd
Winston Salem, NC 27104-4617
Phone (336) 768-7495

National Provider Directory

National Provider Directory

Locations

116 Jonestown Rd
Winston Salem, NC 27104
Phone (336) 768-7495

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861605172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 JONESTOWN RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271044617",
            "telephone_number": "336-768-7495",
            "fax_number": "336-768-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 JONESTOWN RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271044617",
            "telephone_number": "336-768-7495",
            "fax_number": "336-768-7499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. MOSER AND GALLISDORFER,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GALLISDORFER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "DENTIST-PARTNER",
        "authorized_official_telephone_number": "336-768-7495",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "5143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.