Provider Demographics
NPI:1174697734
Name:GILROY, MARK D (DDS)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:D
Last Name:GILROY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11740 W 135TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66221-9395
Mailing Address - Country:US
Mailing Address - Phone:913-681-1900
Mailing Address - Fax:913-681-3136
Practice Address - Street 1:11826 W 135TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66221-9399
Practice Address - Country:US
Practice Address - Phone:913-681-1900
Practice Address - Fax:913-681-3136
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS67401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice