NPIMap

Organization Active NPI

Gladstone Family Dental Associates LLC

  • General Practice Dentistry
  • Gladstone, MO
National Provider Identifier
1902447618
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GLADSTONE FAMILY DENTAL ASSOCIATES LLC
Doing business as
Gladstone Family Dental Associates LLC
Practice address
2019 NE 72ND Street
105
Gladstone, MO 64118
Phone
(816) 452-3420
NPI assigned
Oct 3, 2019
Last updated
Oct 3, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Authorized official

Name
Gregory Dale, DDSNPI 1063639425
Title
Owner
Phone
(816) 452-3420

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

2019 NE 72ND Street
105
Gladstone, MO 64118

Mailing address

2019 NE 72ND Street
105
Gladstone, MO 64118
Phone (816) 452-3420

Other names 1

  • Gladstone Family Dental Associates LLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570060800000",
    "number": "1902447618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 NE 72ND STREET",
            "address_2": "105",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "64118",
            "telephone_number": "816-452-3420",
            "fax_number": "816-454-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2019 NE 72ND STREET",
            "address_2": "105",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "64118",
            "telephone_number": "816-452-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLADSTONE FAMILY DENTAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-03",
        "last_updated": "2019-10-03",
        "status": "A",
        "authorized_official_last_name": "DALE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-452-3420",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gladstone Family Dental Associates LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gladstone, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.