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General NPI Number Information
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NPI Number | 1598011405
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Entity Type | Individual
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Provider Name | KISLEY GALLO ROMANO D.D.S
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Gender | Female
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Dates
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Enumeration Date | 07/28/2012
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 580 CITY CENTER BLVD STE 2E
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-1880
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Country | US
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Telephone | 915-615-9607
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Fax |
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Provider Business Mailing Address
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Address Line | 106 JOY CT
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City | YORKTOWN
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State | VA
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Zip | 23693-3143
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Country | US
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Telephone | 915-615-9607
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401415103
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License Number State | VA
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