Alex C Gilliland, DDS
Individual provider Active NPI Dentist · Holton, KS
NPI 1831391978 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1831391978
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 60480 (KS)
- Practice address
- 1100 Columbine Dr
Holton, KS 66436-8824 - Phone
- (785) 364-3038
- NPI assigned
- Jun 1, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60480 | KS | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 60480 | KS | Yes |
Addresses
Primary practice location
1100 Columbine Dr
Holton, KS 66436-8824
Mailing address
1100 Columbine Dr
Holton, KS 66436-8824
Phone (785) 364-3038
Other providers in Holton, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.