Individual provider Active NPI

David G. Gailey, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Spokane, WA
National Provider Identifier
1093977506
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
DE60353083 Issued in WA
Practice address
2204 E 29TH Ave
Suite #104
Spokane, WA 99203-3961
Phone
(509) 321-1404
Fax
(509) 321-0211
NPI assigned
Jun 26, 2008
Last updated
Oct 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 166 OK
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DE60353083 WA
Student in an Organized Health Care Education/Training Program 390200000X NU
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X DE60353083 WA Primary

Addresses

Primary practice location

2204 E 29TH Ave
Suite #104
Spokane, WA 99203-3961

Mailing address

2204 E 29TH Ave
Suite #104
Spokane, WA 99203-3961
Phone (509) 321-1404

Other identifiers 1

IdentifierTypeStateIssuer
1093977506MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jan 1, 2016 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DE60353083WAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Oral Surgery Plus P.S. Past Accepting new patients
Inland Oral Surgery P.S. Oral and Maxillofacial Surgery Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1093977506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 E 29TH AVE",
            "address_2": "SUITE #104",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992033961",
            "telephone_number": "509-321-1404",
            "fax_number": "509-321-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 E 29TH AVE",
            "address_2": "SUITE #104",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992033961",
            "telephone_number": "509-321-1404",
            "fax_number": "509-321-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAILEY",
        "first_name": "DAVID",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OK",
            "license": "166",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE60353083",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "WA",
            "license": "DE60353083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093977506",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.