Healthcare Provider Details

I. General information

NPI: 1871775437
Provider Name (Legal Business Name): RICHARD STEPHEN GILMAN DDS, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2007
Last Update Date: 12/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9233 WARD PKWY SUITE 330
KANSAS CITY MO
64114-3366
US

IV. Provider business mailing address

9233 WARD PKWY SUITE 330
KANSAS CITY MO
64114-3366
US

V. Phone/Fax

Practice location:
  • Phone: 816-444-8822
  • Fax: 816-444-0492
Mailing address:
  • Phone: 816-444-8822
  • Fax: 816-444-0492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number012701
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: