GALLUP DENTAL GROUP (NPI# 1235457607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235457607 |
| Entity Type | Organization |
| Organization Name | GALLUP DENTAL GROUP |
| Practice Address |
1421 Us 491 Gallup NM 87301 |
| Mailing Address |
1312 Redrock Dr Gallup NM 87301-5686 |
| Practice Telephone | 5058638000 |
| Mailing Telephone | 5059792023 |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2010-05-11 |
| Authorized Official Name | DR. MICHAEL KORY ROWBERRY (OWNER) |
| Authorized Official Telephone | 5058638000 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DD1562 | NM | Dental Providers |
| Street Address |
1421 US 491 |
| City | GALLUP |
| State | NM |
| Zip Code | 87301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790841765 | Bradley Vergien | Dentist | 1421 Us 491, Gallup, NM 87301 | 2006-12-27 |
| 1417275165 | Bradley Vergien Dds, LLC | Dentist | 1421 Us 491, Gallup, NM 87301 | 2010-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154966141 | Karen Marie Acuesta Arboleda | Registered Nurse | 516 E Nizhoni Bld., Gallup, NM 87301 | 2019-11-13 |
| 1811453707 | Kelly Dahn | Respiratory Therapist, Certified | 516 E Hizhoni Blvd, Gallup, NM 87301 | 2019-02-15 |
| 1417411232 | Frances Griego | Registered Nurse | 28b Alma Drive, Gallup, NM 87301 | 2019-01-25 |
| 1891267605 | Hozho Academy | Occupational Therapist | 306 Nm-564, Gallup, NM 87301 | 2018-12-19 |
| 1922514686 | Jjdac, LLC | Ambulance | 208 W Maloney Ave, Gallup, NM 87301 | 2017-12-18 |
| 1508382698 | Katherine L Kuehl | Pharmacist | Walgreens 1870 E Historic Highway 66, Galliup, NM 87301 | 2017-08-21 |
| 1497285001 | Jessica Kate Savant | Registered Nurse | 516 E Nazhoni Blvd, Gallup, NM 87301 | 2017-06-15 |
| 1770013385 | Nicole Aline Pavy | Registered Nurse | 516 E. Nizhioni Blvd, Gallup, NM 87301 | 2017-06-15 |
| 1730612276 | Camie Renee Nelson | Contractor | 121 Bishop Drive, Gallup, NM 87301 | 2017-04-11 |
| 1508216227 | Marriah Silversmith | Technician, Other | 3426 Blue Hill Ave, Gallup, NM 87301 | 2016-06-14 |
| Find all providers in zip 87301 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982033700 | Outreach Dental, LLC | Dentist | 1700 Helena Dr, Gallup, NM 87301-5610 | 2013-11-02 |
| 1114281508 | Erin Maille Montano | Dentist | 802 Us Highway 491, Gallup, NM 87301-5388 | 2012-06-29 |
| 1215290044 | Jared A Montano | Dentist | 214 W Aztec Ave, Gallup, NM 87301-6302 | 2012-06-18 |
| 1639361371 | Small Fry Dentistry PC | Dentist | 1401 Linda Dr, Gallup, NM 87301-5615 | 2007-08-16 |
| 1790841765 | Bradley Vergien | Dentist | 1421 Us 491, Gallup, NM 87301 | 2006-12-27 |
| 1437165255 | Lidio Gregorio Rainaldi Jr. | Dentist | 501 Nizhoni Blvd, Ste A, Gallup, NM 87301 | 2006-08-01 |
| 1144889825 | Jaden Willard | Dentist | 1601 S Second St, Gallup, NM 87301-5816 | 2019-06-06 |
| 1821544701 | Paul Tran | Dentist | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2016-08-30 |
| 1346644671 | Jacob Jennings | Dentist | 1601 S Second St, Gallup, NM 87301-5816 | 2014-10-15 |
| 1013353127 | Gallup Childrens Dentistry | Dentist | 802 Us Highway 491, Gallup, NM 87301-5388 | 2013-05-15 |
| Find all providers in GALLUP | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.