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NPI Code Detail

MEDICARE: DR. KISLEY GALLO ROMANO D.D.S

MEDICARE: DR. KISLEY GALLO ROMANO 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
11223G0001XGeneral Practice Dentistry0401415103VA

General Provider Information

NPI Number : 1598011405
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KISLEY GALLO ROMANO D.D.S
Provider Business Mailing Address
First Line : 106 JOY CT
Second Line :
City : YORKTOWN
State : VA
Zip : 23693-3143
Country : US
Telephone Number : 915-615-9607
Fax Number :
Provider Business Practice Location Address
First Line : 580 CITY CENTER BLVD STE 2E
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23606-1880
Country : US
Telephone Number : 915-615-9607
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2012
Last Update Date : 12/19/2025

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