Tristan Galloway DDS PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

D4321 Issued in ID

Legal business name

TRISTAN GALLOWAY DDS PLLC

Practice address

820 17TH Ave S
Nampa, ID 83651-4740

Phone

(208) 466-4261

Fax

(208) 466-6288

NPI assigned

Sep 3, 2014

Organization subpart

No

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

Authorized official

Name

Tristan Sumner Galloway, DDS

Title

Oowner/Operator

Phone

(208) 466-4261

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409702400000",
    "number": "1942600390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 17TH AVE S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836514740",
            "telephone_number": "208-466-4261",
            "fax_number": "208-466-6288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 17TH AVE S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836514740",
            "telephone_number": "208-466-4261",
            "fax_number": "208-466-6288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISTAN GALLOWAY DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-03",
        "last_updated": "2014-09-03",
        "status": "A",
        "authorized_official_last_name": "GALLOWAY",
        "authorized_official_first_name": "TRISTAN",
        "authorized_official_middle_name": "SUMNER",
        "authorized_official_title_or_position": "OOWNER/OPERATOR",
        "authorized_official_telephone_number": "208-466-4261",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "ID",
            "license": "D4321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Nampa, ID
• Providers in Nampa, ID by specialty
• Dentist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; 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.