Peter M Gray, DDS

Individual provider Active NPI General Practice Dentistry · Independence, MO

NPI 1861494585 · NPPES record last updated Jul 13, 2026

Key facts

NPI
1861494585
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
13315 (MO)
Practice address
1520 E 23Rd St S
Independence, MO 64055-1657
Phone
(816) 252-9190
Fax
(816) 252-9390
NPI assigned
Aug 12, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
13315MOMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13315 MO Yes

Addresses

Primary practice location

1520 E 23Rd St S
Independence, MO 64055-1657

Mailing address

916 Hackney CT
Lees Summit, MO 64081-2303

Other providers in Independence, MO

All providers in Independence, MO · General Practice Dentistry in Missouri

Sources for this page

Verify at the official NPI Registry.