NPIMap

Organization Active NPI

Dale M. Gallagher, D.D.S., P.a.

  • Oral and Maxillofacial Surgery (Dentist)
  • Austin, TX
National Provider Identifier
1992900559
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
14399 Issued in TX
Legal business name
DALE M. GALLAGHER, D.D.S., P.A.
Practice address
12210 Pecan St
Austin, TX 78727-6109
Phone
(512) 258-1636
Fax
(512) 258-6352
NPI assigned
Jun 15, 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
Mrs. Nancy Darlene Young
Title
Practice Manager
Phone
(512) 258-1636

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 14399 TX Primary

Addresses

Primary practice location

12210 Pecan St
Austin, TX 78727-6109

Mailing address

12210 Pecan St
Austin, TX 78727-6109
Phone (512) 258-1636

National Provider Directory

National Provider Directory

Locations

12210 Pecan St
Austin, TX 78727
Phone (512) 258-1636

Practitioners & affiliated clinicians

Practitioners 3

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": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992900559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12210 PECAN ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787276109",
            "telephone_number": "512-258-1636",
            "fax_number": "512-258-6352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12210 PECAN ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787276109",
            "telephone_number": "512-258-1636",
            "fax_number": "512-258-6352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALE M. GALLAGHER, D.D.S., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "DARLENE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "512-258-1636",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "14399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

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.