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1881008472 NPI number — ROBIN LEE GALLARDI BSC DDS MSC FRCD(C)

NPI Number: 1881008472
Health Care Provider/Practitioner: ROBIN LEE GALLARDI BSC DDS MSC FRCD(C)

Information about “1881008472” NPI (ROBIN LEE GALLARDI BSC DDS MSC FRCD(C)) exists in 1881008472 in HTML format HTML  |  1881008472 in plain Text format TXT  |  1881008472 in PDF (Portable Document Format) PDF  |  1881008472 in an XML format XML  formats.

NPI Number : 1881008472 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1881008472",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GALLARDI",
    "FirstName": "ROBIN",
    "MiddleName": "LEE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "BSC DDS MSC FRCD(C)",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "37 GROSVENOR STREET APT 1607",
    "SecondLineMailingAddress": "ONTARIO CANADA M4Y 3G5",
    "MailingAddressCityName": "TORONTO",
    "MailingAddressStateName": "ONTARIO",
    "MailingAddressPostalCode": "M4Y 3G5",
    "MailingAddressCountryCode": "CA",
    "MailingAddressTelephoneNumber": "416-877-1231",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "15300 WEST AVE",
    "SecondLinePracticeLocationAddress": "SUITE 113",
    "PracticeLocationAddressCityName": "ORLAND PARK",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60462-4600",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "708-348-4000",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/11/2014",
    "LastUpdateDate": "06/11/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "122300000X",
          "TaxonomyName": "Dentist",
          "LicenseNumber": "019029722",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1223S0112X",
          "TaxonomyName": "Oral and Maxillofacial Surgery (Dentist)",
          "LicenseNumber": "021002571",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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