Healthcare Provider Details

I. General information

NPI: 1104697838
Provider Name (Legal Business Name): GAGE WILLIAMS DDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2024
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 N OAK TRAFFICWAY STE 203
KANSAS CITY MO
64118
US

IV. Provider business mailing address

6301 N OAK TRAFFICWAY STE 203
KANSAS CITY MO
64118
US

V. Phone/Fax

Practice location:
  • Phone: 801-636-2824
  • Fax:
Mailing address:
  • Phone: 816-922-0123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. GAGE WILLIAMS
Title or Position: OWNER/OPERATOR
Credential: DDS
Phone: 816-922-0123