GILLIS FAMILY DENTISTRY (NPI# 1972992162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972992162 |
| Entity Type | Organization |
| Organization Name | GILLIS FAMILY DENTISTRY |
| Practice Address |
2000 N Gaines Dr Clinton MO 64735-1132 |
| Practice Telephone | 6608856933 |
| Practice Fax Number | 6608856935 |
| Mailing Telephone | 6608856933 |
| Mailing Fax Number | 6608856935 |
| Enumeration Date | 2015-01-12 |
| Last Update Date | 2015-01-12 |
| Authorized Official Name | KRYSTAL GILLIS (DDS) |
| Authorized Official Telephone | 6609956933 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
2008016892 | MO | Dental Providers |
| Street Address |
2000 N GAINES DR |
| City | CLINTON |
| State | MO |
| Zip Code | 64735-1132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275539322 | Robert J Sexauer | Dentist | 2000 N Gaines Dr, Ste A, Clinton, MO 64735-1132 | 2005-06-23 |
| 1396304283 | Ryan Michael Peters | Dentist | 2000 N Gaines Dr, Clinton, MO 64735-1132 | 2019-06-13 |
| 1790257921 | Compass Health, Inc. | Clinic/Center | 2000 N Gaines Dr, Clinton, MO 64735-1132 | 2018-12-28 |
| 1811482326 | Maggie Heiman | Dentist | 2000 N Gaines Dr, Clinton, MO 64735-1132 | 2018-06-27 |
| 1326426172 | Allison Layne Manz | Dentist | 2000 N Gaines Dr, Clinton, MO 64735-1132 | 2015-05-13 |
| 1699114587 | Casey Larae Zook | Dentist | 2000 N Gaines Dr, Clinton, MO 64735-1132 | 2013-06-24 |
| 1831535368 | Christian Nicole Campbell | Dental Hygienist | 2000 N Gaines Dr, Clinton, MO 64735-1132 | 2013-05-10 |
| 1477884351 | Krystal Gillis | Dentist | 2000 N Gaines Dr, Clinton, MO 64735-1132 | 2010-01-17 |
| 1699847517 | Bernard Thomas Henehan | Dentist | 2000 N Gaines Dr, Clinton, MO 64735-1132 | 2006-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730543778 | Courtney Briggs | Speech-Language Pathologist | 502 S. 5th, Clinton, MO 64735 | 2016-04-06 |
| 1447669924 | James Taylor Thatcher II | Counselor | 1800 Community Drive, Clinton, MO 64735 | 2014-08-08 |
| 1205271897 | Rocksheng Zhong | Psychiatry & Neurology | 1800 Community Dr, Clinton, MO 64735 | 2013-05-08 |
| 1407196272 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1501 E Ohio St, Clinton, MO 64735 | 2013-02-15 |
| 1265614176 | Kristal Lynn Moran | Registered Nurse | 1600 N Second St, Clinton, MO 64735 | 2007-12-03 |
| 1174653406 | Gary Allen Groff | Dentist | 1100 E Ohio St, Clinton, MO 64735 | 2007-03-06 |
| 1306908512 | Andrea Jolynn Bruck | Dentist | 906 E Ohio, Clinton, MO 64735 | 2006-12-14 |
| 1992873889 | Golden Valley Memorial Hospital Home Services | Home Health | 1600 North Second Street, Clinton, MO 64735 | 2006-12-01 |
| 1033205521 | Bradley Mark Townsend | Family Medicine | 1413 South Second Street, Clinton, MO 64735 | 2006-10-04 |
| 1871688473 | Michael Jay Harrison | Chiropractor | 704 E. Ohio, Clinton, MO 64735 | 2006-10-03 |
| Find all providers in zip 64735 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740898584 | Jamie Beavers Dds, P.a. | Dentist | 354 Main Street, Clinton, AR 72031 | 2020-07-17 |
| 1376012724 | John Melvin Goolsby Jr. | Dentist | 457 Highway 80 East, Clinton, MS 39056 | 2018-11-15 |
| 1508386616 | Blaire Alford | Dentist | 380 Highway 80 E Ste A, Clinton, MS 39056-4748 | 2017-06-21 |
| 1811427677 | Total You Family Dentistry | Dentist | 9135 Piscataway Rd Ste 105, Clinton, MD 20735-2548 | 2017-06-14 |
| 1114386802 | Christopher A Fallago | Dentist | 8 E Main St Ste 202, Clinton, CT 06413-2058 | 2016-02-23 |
| 1245636174 | Rick Canty | Dentist | 201a S Washington St, Clinton, KY 42031-1440 | 2014-11-04 |
| 1962830349 | Drs. Roh, Park and Hwang, LLC | Dentist | 7700 Old Branch Ave Ste E102, Clinton, MD 20735-1628 | 2013-10-23 |
| 1912243247 | Clinton Dental Group, LLP | Dentist | 1737 North 2000 West, Suite G, Clinton, UT 84015 | 2012-12-13 |
| 1346504230 | Paul N Singh | Dentist | 8913 Woodyard Rd, Clinton, MD 20735-4257 | 2012-06-26 |
| 1497040489 | Beautiful Smiles, L.L.C. | Dentist | 9001 Stuart Ln, Clinton, MD 20735-2744 | 2011-06-17 |
| Find all providers in CLINTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.