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General NPI Number Information
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NPI Number | 1164114047
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Entity Type | Individual
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Provider Name | GILLIAN ELISE CASEY DMD, MSD
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Gender | Female
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Dates
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Enumeration Date | 05/22/2023
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Last Update Date | 07/12/2025
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Provider Practice Location Address
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Address Line | 8727 OLD BARDSTOWN RD
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City | LOUISVILLE
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State | KY
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Zip | 40291-4490
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Country | US
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Telephone | 502-200-1173
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Fax |
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Provider Business Mailing Address
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Address Line | 3709 HURSTBOURNE RIDGE BLVD
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City | LOUISVILLE
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State | KY
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Zip | 40299-6507
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Country | US
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Telephone | 859-613-2481
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12014069A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 1239
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License Number State | KY
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