Active NPI
Kaitlin Campbell Gillham, DDS
- Pediatric Dentistry
- Irving, TX
National Provider Identifier
1295359628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 39344
- Practice address
- 3219 N Macarthur Blvd Ste 100
Irving, TX 75062-8805 - Phone
- (756) 925-2972
- NPI assigned
- Jun 1, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 39344 | TX | Primary |
Addresses
Primary practice location
3219 N Macarthur Blvd Ste 100
Irving, TX 75062-8805
Mailing address
2427 Allen St Apt 421
Dallas, TX 75204-2553
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39344 | TX | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690761600000",
"number": "1295359628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2427 ALLEN ST APT 421",
"city": "DALLAS",
"state": "TX",
"postal_code": "752042553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3219 N MACARTHUR BLVD STE 100",
"city": "IRVING",
"state": "TX",
"postal_code": "750628805",
"telephone_number": "756-925-2972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLHAM",
"first_name": "KAITLIN",
"middle_name": "CAMPBELL",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-01",
"last_updated": "2023-07-31",
"certification_date": "2023-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "39344",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.