GALLERIA ORAL AND MAXILLOFACIAL SURGERY (NPI# 1407279177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407279177 |
| Entity Type | Organization |
| Organization Name | GALLERIA ORAL AND MAXILLOFACIAL SURGERY |
| Other Organization Name | ALEXANDER O. ANTIPOV, D.D.S., INC |
| Practice Address |
911 Reserve Drive Suite #150 Roseville CA 95678 |
| Practice Telephone | 9167832110 |
| Practice Fax Number | 9167832111 |
| Mailing Telephone | 9167832110 |
| Mailing Fax Number | 9167832111 |
| Enumeration Date | 2014-01-30 |
| Last Update Date | 2014-01-30 |
| Authorized Official Name | YELENA MYALIK (OFFICE MANAGER) |
| Authorized Official Telephone | 9167832110 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
CA | Dental Providers |
| Other Name | Type Code |
|---|---|
| Alexander O. Antipov, D.D.S., Inc | Former Legal Business Name - Organization |
| Street Address |
911 RESERVE DRIVE SUITE #150 |
| City | ROSEVILLE |
| State | CA |
| Zip Code | 95678 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750553889 | Alexander Antipov | Dentist | 911 Reserve Drive, Suite 150, Roseville, CA 95678-1383 | 2008-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114533064 | Alexander V. Antipov, D.d.s., Inc. | Dentist | 911 Reserve Drive, Suite 150, Roseville, CA 95678 | 2020-09-16 |
| 1396378980 | David F Shirley M D P C | Family Medicine | 4001 Impala Circle, Roseville, CA 95678 | 2020-02-21 |
| 1083256051 | Rosemary Ellen Robben | Community Health Worker | Cirby Wellness Center 101 Cirby Hills Drive, Roseville, CA 95678 | 2019-10-11 |
| 1588217236 | Kaiser Foundation Health Plan Inc | Pharmacy | 1021 Riverside Ave, Roseville, CA 95678 | 2019-07-22 |
| 1174093793 | Neftali Hernandez | Behavior Technician | 1100 Roseville Parkway Apt 1021, Roseville, CA 95678 | 2018-11-26 |
| 1467951798 | Amarantha Martinez | Behavior Technician | 1900 Quail Ridge Road, #99, Roseville, CA 95678 | 2018-02-01 |
| 1093231276 | Compassionate Home Health, Ltd | Home Health | 1100 Melody Lane, Suite 106, Roseville, CA 95678 | 2017-08-18 |
| 1629598891 | Jimena Andrade Martins | Behavior Technician | 602 Atkinson Street, Roseville, CA 95678 | 2017-06-20 |
| 1891221057 | Zride Inc | Taxi | 106 Church Street, Suite 2, Roseville, CA 95678 | 2017-05-10 |
| 1568997641 | Joline Trinh | Pharmacist | 1030 Pleasant Grove Boulevard, Roseville, CA 95678 | 2017-04-26 |
| Find all providers in zip 95678 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114533064 | Alexander V. Antipov, D.d.s., Inc. | Dentist | 911 Reserve Drive, Suite 150, Roseville, CA 95678 | 2020-09-16 |
| 1861796393 | Parshan Namiranian | Dentist | 9225 Sierra College Blvd, Roseville, CA 95661-5919 | 2010-12-24 |
| 1093044927 | Sierra Foothills Oral & Maxillofacial Surgery Group | Dentist | 2350 Professional Drive, Suite 400, Roseville, CA 95661-7747 | 2009-12-24 |
| 1750553889 | Alexander Antipov | Dentist | 911 Reserve Drive, Suite 150, Roseville, CA 95678-1383 | 2008-03-28 |
| 1063609030 | Alexander Rabinovich | Dentist | 9655 Pinehurst Dr, Roseville, CA 95747-6336 | 2007-10-03 |
| 1992739379 | Henry Gasson Bryan | Dentist | 20805 E 12 Mile Rd, Suite 110, Roseville, MI 48066-6502 | 2006-07-10 |
| 1255337564 | Lawrence H Kent | Dentist | 1912 Lexington Ave N, Roseville, MN 55113-6113 | 2005-06-22 |
| 1447641295 | Christopher Michael Rivers | Dentist | 1835 County Road C W Ste 200, Roseville, MN 55113-1353 | 2015-02-16 |
| 1871982520 | Solutions To Smile About Inc | Dentist | 730 Sunrise Ave, Suite 138, Roseville, CA 95661-4567 | 2015-01-19 |
| 1245553924 | Alexander Antipov Inc | Dentist | 927 Reserve Dr, Suite A, Roseville, CA 95678 | 2010-03-09 |
| Find all providers in ROSEVILLE | ||||
Please comment or provide details below to improve the information on GALLERIA ORAL AND MAXILLOFACIAL SURGERY.
| 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.