Creighton F Gallagher, D.D.S.

Individual provider Active NPI General Practice Dentistry · Grandview, MO

NPI 1104147404 · NPPES record last updated Jun 21, 2010

Key facts

NPI
1104147404
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2010018006 (MO)
Practice address
13051 S US Highway 71
Grandview, MO 64030-2525
Phone
(816) 966-9450
NPI assigned
Jun 21, 2010
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2010018006MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Emily Katherine Handley, DDS, PC General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2010018006 MO Yes

Addresses

Primary practice location

13051 S US Highway 71
Grandview, MO 64030-2525

Mailing address

10810 W 140TH Ter
Overland Park, KS 66221-8085

Other providers in Grandview, MO

All providers in Grandview, MO · General Practice Dentistry in Missouri

Sources for this page

Verify at the official NPI Registry.