Individual provider Active NPI

Mark D. Gilroy, D.D.S.

  • General Practice Dentistry
  • Overland Park, KS
National Provider Identifier
1174697734
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6740 Issued in KS
Practice address
11826 W 135TH St
Overland Park, KS 66221-9399
Phone
(913) 681-1900
Fax
(913) 681-3136
NPI assigned
Nov 17, 2006
Last updated
Sep 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6740 KS Primary

Addresses

Primary practice location

11826 W 135TH St
Overland Park, KS 66221-9399

Mailing address

11740 W 135TH St
Overland Park, KS 66221-9395
Phone (913) 681-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150728003286 KS Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3779897335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gilroy Dental Care, LLC General Practice CurrentSince Sep 24, 2023 Accepting new patients
Mark D. Gilroy DDS, PA General Practice CurrentSince Sep 24, 2023 Accepting new patients

Locations

11826 W 135th St
Overland Park, KS 66221
Phone (913) 681-1900

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1174697734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11740 W 135TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662219395",
            "telephone_number": "913-681-1900",
            "fax_number": "913-681-3136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11826 W 135TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662219399",
            "telephone_number": "913-681-1900",
            "fax_number": "913-681-3136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILROY",
        "first_name": "MARK",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "6740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.