Gladstone Family Dentistry L.L.C.

Primary specialty

DentistTaxonomy code 122300000X

License

011945 Issued in MO

Legal business name

GLADSTONE FAMILY DENTISTRY L.L.C.

Practice address

6301 N Oak Trfy
Suite 202
Gladstone, MO 64118-4705

Phone

(816) 452-2420

Fax

(816) 777-0836

NPI assigned

Jan 11, 2008

Last updated

Jan 11, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dee Heiskell

Title

Office Manager

Phone

(816) 452-2420

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Reese Graue II, D.D.S.

  • General Practice Dentistry
  • Gladstone, MO
  • NPI 1033379581
  NPD (past)
• Jerald Hamblin

  • Dentist
  • Gladstone, MO
  • NPI 1922281971
  NPD (past)

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200009600000",
    "number": "1730365529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 N OAK TRFY",
            "address_2": "SUITE 202",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "641184705",
            "telephone_number": "816-452-2420",
            "fax_number": "816-777-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 N OAK TRFY",
            "address_2": "SUITE 202",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "641184705",
            "telephone_number": "816-452-2420",
            "fax_number": "816-777-0836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLADSTONE FAMILY DENTISTRY L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-11",
        "last_updated": "2008-01-11",
        "status": "A",
        "authorized_official_last_name": "HEISKELL",
        "authorized_official_first_name": "DEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "816-452-2420"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": "011945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "09692040",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Gifford, RPH
• Lisa Gile, M.S. CCC-SLP
• Gladstone Family Care, LLC
• Gladstone Family Dental Associates LLC
• Gladstone Family Dental Group.P.C. & Associates
• Gladstone Urgent Care, LLC
• Brandi Glidden
• James J Good, DPM
• Saryn Graham
• John Reese Graue II, D.D.S.

• Dentist in Gladstone, MO
• Providers in Gladstone, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; 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.