Provider Demographics
NPI:1538262688
Name:GAIK, RICHARD BRADLEY (DDS)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:BRADLEY
Last Name:GAIK
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 1:8568 N CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64158
Mailing Address - Country:US
Mailing Address - Phone:816-792-0801
Mailing Address - Fax:816-415-2795
Practice Address - Street 1:8568 N CHURCH RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64158
Practice Address - Country:US
Practice Address - Phone:816-792-0801
Practice Address - Fax:816-415-2795
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20001584131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice