MEDICARE: DANIEL R GANO PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics

General Provider Information

NPI Number	:	1154271708
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL R GANO PLLC

Provider Business Mailing Address
First Line	:	5302 W HACKAMORE DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85083-4419
Country	:	US
Telephone Number	:	901-605-0411
Fax Number	:

Provider Business Practice Location Address
First Line	:	26425 NORTH LAKE PLEASANT PARKWAY,
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85383
Country	:	US
Telephone Number	:	901-605-0411
Fax Number	:

Authorized Official
Title or Position	:	ENDODONTIST
Name	:	DANIEL R GANO
Credential	:	DDS
Telephone Number	:	901-605-0411

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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