Gary William Long, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

1600 S 4TH Ave
Ste 110
Morton, IL 61550-2889

Phone

(309) 263-2781

Fax

(309) 263-4161

NPI assigned

Apr 25, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417176348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S 4TH AVE",
            "address_2": "STE 110",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615502889",
            "telephone_number": "309-263-2781",
            "fax_number": "309-263-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S 4TH AVE",
            "address_2": "STE 110",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615502889",
            "telephone_number": "309-263-2781",
            "fax_number": "309-263-4161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "GARY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Rae Layne, APRN
• Hannah Kate Lee, RD LDN
• Jennifer Lynn Litherland, RPH
• Autumn Lloyd, MA
• Erika Kay Long, D.D.S.
• Christopher S Loudermilk, DMD
• Daniel Andrew Lovell, DMD, MSD
• Rachel Lowery
• Ronald Luce
• Laura Lee Luginbuhl, SLP

• General Practice Dentistry in Morton, IL
• Providers in Morton, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.