Individual provider Active NPI

William J Gleeson, DDS

  • General Practice Dentistry
  • Kansas City, MO
National Provider Identifier
1407925415
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
013106 Issued in MO
Practice address
1050 W Blue Ridge Blvd
Lower Level
Kansas City, MO 64145-1216
Phone
(816) 361-1123
NPI assigned
Nov 6, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 013106 MO Primary

Addresses

Primary practice location

1050 W Blue Ridge Blvd
Lower Level
Kansas City, MO 64145-1216

Mailing address

1050 W Blue Ridge Blvd
Lower Level
Kansas City, MO 64145-1216
Phone (816) 361-1123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20150109000219 MO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1557684040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013106MOMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407925415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 W BLUE RIDGE BLVD",
            "address_2": "LOWER LEVEL",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641451216",
            "telephone_number": "816-361-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W BLUE RIDGE BLVD",
            "address_2": "LOWER LEVEL",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641451216",
            "telephone_number": "816-361-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEESON",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "013106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.