Provider Demographics
NPI:1902882582
Name:GANGI, GREGORY JOSEPH (DDS)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:JOSEPH
Last Name:GANGI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BHC ATSUGI
Mailing Address - Street 2:PSC 477 BOX 2
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96306
Mailing Address - Country:JP
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BHC ATSUGI
Practice Address - Street 2:PSC 477 BOX 2
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96306
Practice Address - Country:JP
Practice Address - Phone:264-3612
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0516291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice