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Deactivated NPI 1023015591 Deactivated / Inactive NPI Male Practitioner

Dr. Gary C London , DDS

Dentist - General Practice • Fairview Heights, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Gary London has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 30, 2005
NPI Deactivation Date April 17, 2025
Total Practice Duration ~20 Years of Practice (2005 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Gary London, DDS was a registered Dentist - General Practice practicing in Fairview Heights, IL. Throughout an active medical career spanning 20 years, Dr. London provided care at the practice location at 5 BLUFF CT until profile deactivation on 2025-04-17.

Practice Location & Contact Primary Location

Practice Address

5 Bluff Ct

Fairview Heights, IL 622082630

Telephone 6183981222

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Fairview Heights, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
5 Specialists

Practicing in Fairview Heights, IL (5581 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IL 19A13398

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.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated April 17, 2025

Record deactivated on April 17, 2025

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 5 BLUFF CT, FAIRVIEW HEIGHTS, IL 622082630 (Tel: 6183981222)

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Updated Business Mailing Address July 08, 2007

Registered at 5 BLUFF CT, FAIRVIEW HEIGHTS, IL 622082630

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Provider Name / Credentials Updated July 08, 2007

Recorded as GARY LONDON, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #19A13398 in IL)

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Initial NPI Registration & Enumeration June 30, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1023015591
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 30, 2005
Last Update: July 08, 2007
Deactivation Date: April 17, 2025

Mailing Address

5 Bluff Ct

Fairview Heights, IL 622082630

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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