Michael Gardner, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D009412 Issued in AZ

Practice address

1806 Broadway Blvd
Kilgore, TX 75662-3520

Phone

(903) 984-1108

NPI assigned

Jun 9, 2010

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Michael B Gardner PC

  • Dental Clinic/Center
  • Kilgore, TX
  • NPI 1912271420
  NPD (past) Authorized official
• Meno Group, PLLC

  • General Practice Dentistry
  • Kilgore, TX
  • NPI 1003267212
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1033439286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 BROADWAY BLVD",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756623520",
            "telephone_number": "903-984-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 BROADWAY BLVD",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756623520",
            "telephone_number": "903-984-1108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-09",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "0025450",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D009412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russell C Fisher, R.PH.
• James E. Foster, MD
• Jennifer Darlene Franks, BSN RN
• La Tamera D Fry, LAT
• Darrell Layne Ganus, MED, LAT, ATC
• Get to the Point Wellness PLLC
• Shirley Jane Goetze, CCC/SLP
• Hailey Goza
• Paul A Grant Jr, MD
• Grant-Moore Center for Behavioral Health, Inc.

• General Practice Dentistry in Kilgore, TX
• Providers in Kilgore, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.