MEDICARE: DR. JOSE E GALLEGOS D.D.S.

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	1223G0001X	General Practice Dentistry	0401007260	VA

General Provider Information

NPI Number	:	1326114950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE E GALLEGOS D.D.S.

Provider Business Mailing Address
First Line	:	6508 WOODLAKE VILLAGE CIR
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23112-2200
Country	:	US
Telephone Number	:	804-739-9190
Fax Number	:	804-739-9543

Provider Business Practice Location Address
First Line	:	6508 WOODLAKE VILLAGE CIR STE 200
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23112-2200
Country	:	US
Telephone Number	:	804-739-9190
Fax Number	:	804-739-9543

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2006
Last Update Date	:	11/10/2025

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