Individual provider Active NPI

Gary Kijanka, DMD

  • Dentist
  • Saint Louis, MO
National Provider Identifier
1770676645
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2025051251 Issued in MO
Practice address
6979 Chippewa St
Saint Louis, MO 63109-3039
Phone
(561) 307-1361
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2025051251 MO Primary
General Practice Dentistry 1223G0001X DN14241 FL

Addresses

Primary practice location

6979 Chippewa St
Saint Louis, MO 63109-3039

Mailing address

10333 N Military TRL Ste B
West Palm Beach, FL 33410-4601
Phone (561) 776-3116

Other practice location 1

10333 N Military Trl
Suite B
West Palm Beach, FL 33410-4601
Phone (561) 776-3116

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

LicenseStateTypeSpecialty
2025051251MOMDDentist
DN14241FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ramani Dentistry PA General Practice PastSince Sep 28, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1770676645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10333 N MILITARY TRL STE B",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334104601",
            "telephone_number": "561-776-3116",
            "fax_number": "561-776-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6979 CHIPPEWA ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631093039",
            "telephone_number": "561-307-1361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10333 N Military Trl",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334104601",
            "country_code": "US",
            "telephone_number": "561-776-3116",
            "fax_number": "561-776-3165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIJANKA",
        "first_name": "GARY",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2025051251",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN14241",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2026; 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.