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NPI Code Detail

MEDICARE: DR. TARA MARIE GABRIEL DDS

MEDICARE: DR. TARA MARIE GABRIEL DDS
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
11223G0001XGeneral Practice Dentistry2001019345MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588643381
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TARA MARIE GABRIEL DDS
Provider Business Mailing Address
First Line : 825 EUCLID AVE
Second Line :
City : KANSAS CITY
State : MO
Zip : 64124-2323
Country : US
Telephone Number : 816-474-4920
Fax Number :
Provider Business Practice Location Address
First Line : 825 EUCLID AVE
Second Line :
City : KANSAS CITY
State : MO
Zip : 64124-2323
Country : US
Telephone Number : 816-474-4920
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2006
Last Update Date : 09/11/2023

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