Miriam Lizeth Galvan Tenorio, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14967 Issued in MN

Practice address

4131 26TH St NW Ste 1
Rochester, MN 55901-8342

Phone

(507) 282-8082

NPI assigned

Jul 12, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Lakewood Dental

  • General Practice Dentistry
  • Rochester, MI
  • NPI 1063542462
  NPD (past)

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

{
    "created_epoch": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1952080566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2802 TEE TIME RD SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559043918",
            "telephone_number": "507-271-9627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 26TH ST NW STE 1",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559018342",
            "telephone_number": "507-282-8082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALVAN TENORIO",
        "first_name": "MIRIAM",
        "middle_name": "LIZETH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-12",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Galles, NP
• Alice Gallo de Moraes, M.D.
• Alex Juan Galloway, PA-C
• Maria Cristina Gallup, MSN, RN, CCNS-N
• Tiffany Jayne Galush, PA
• Brianna Conte Galvin, MD
• Oisin Thomas Galvin, MBBCH
• Mauricio Emilio Gamez Haro, M.D.
• Kelley Gammell, LPCC
• Donald B Gammon, PHD

• General Practice Dentistry in Rochester, MN
• Providers in Rochester, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.