Individual provider Active NPI

Amy Leigh Gillihan, DMD

  • Periodontics
  • Independence, MO
National Provider Identifier
1972785533
Registry record updated Jan 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
2003010617 Issued in MO
Practice address
3151 S 291 Hwy
Suite B
Independence, MO 64057-2602
Phone
(816) 373-5400
NPI assigned
Dec 5, 2007
Last updated
Jan 19, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 2003010617 MO Primary

Addresses

Primary practice location

3151 S 291 Hwy
Suite B
Independence, MO 64057-2602

Mailing address

3151 S 291 Hwy
Suite B
Independence, MO 64057-2602
Phone (816) 373-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20140915001984 MO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3971722430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2003010617MOMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295395200000",
    "number": "1972785533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 S 291 HWY",
            "address_2": "SUITE B",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572602",
            "telephone_number": "816-373-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 S 291 HWY",
            "address_2": "SUITE B",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572602",
            "telephone_number": "816-373-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIHAN",
        "first_name": "AMY",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-05",
        "last_updated": "2011-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MO",
            "license": "2003010617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.