Individual provider Active NPI

Gordon R. Ediger, DDS

  • General Practice Dentistry
  • Leawood, KS
National Provider Identifier
1912948134
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6794 Issued in KS
Practice address
12260 State Line Rd
Leawood, KS 66209-1256
Phone
(913) 345-2929
Fax
(913) 345-0376
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6794 KS Primary

Addresses

Primary practice location

12260 State Line Rd
Leawood, KS 66209-1256

Mailing address

12260 State Line Rd
Leawood, KS 66209-1256
Phone (913) 345-2929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160401000454 KS Order and Referring Only - DentistPractitioner - Dentist 7911204128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6794KSMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1912948134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12260 STATE LINE RD",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662091256",
            "telephone_number": "913-345-2929",
            "fax_number": "913-345-0376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12260 STATE LINE RD",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662091256",
            "telephone_number": "913-345-2929",
            "fax_number": "913-345-0376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDIGER",
        "first_name": "GORDON",
        "middle_name": "R.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "6794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leawood, KS

Sources for this page

Verify at the official NPI Registry.