Provider Demographics
NPI:1134559636
Name:GALADA, MICHAEL RYAN (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:RYAN
Last Name:GALADA
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 1:9237 REGENTS RD
Mailing Address - Street 2:APT 120
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-9184
Mailing Address - Country:US
Mailing Address - Phone:347-893-1862
Mailing Address - Fax:
Practice Address - Street 1:246 TOWN CENTER PKWY
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-5803
Practice Address - Country:US
Practice Address - Phone:619-312-6006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-19
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX295811223P0221X, 1223G0001X
CA652401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223P0221XDental ProvidersDentistPediatric Dentistry