MEDICARE: GAGE WILLIAMS DDS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1104697838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GAGE WILLIAMS DDS LLC

Provider Business Mailing Address
First Line	:	6301 N OAK TRAFFICWAY
Second Line	:	STE 203
City	:	KANSAS CITY
State	:	MO
Zip	:	64118
Country	:	US
Telephone Number	:	816-922-0123
Fax Number	:

Provider Business Practice Location Address
First Line	:	6301 N OAK TRAFFICWAY
Second Line	:	STE 203
City	:	KANSAS CITY
State	:	MO
Zip	:	64118
Country	:	US
Telephone Number	:	801-636-2824
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	DR. GAGE WILLIAMS
Credential	:	DDS
Telephone Number	:	816-922-0123

Provider Enumeration Date	:	01/11/2024
Last Update Date	:	02/03/2026

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