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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ALLY MARIE GOURLEY
NPI 1033809181
Dentist - Pediatric Dentistry in Saint Louis, MO

Active since May 11, 2023PECOS Enrolled
3320 RUTGER ST, SAINT LOUIS, MO 63104(314) 977-7336 Get Directions Write a Review

NPPES record last updated: July 22, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 22, 2026, May 11, 2023 (2 updates tracked since 2023).

About Ally Marie Gourley NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALLY MARIE GOURLEY (NPI 1033809181) is an individual pediatric dentistry provider in Saint Louis, Missouri, licensed in Missouri (2026026685) and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1033809181
Entity TypeIndividualFemale
Primary Taxonomy1223P0221X
Provider Legal NameALLY MARIE GOURLEY
Location Address3320 RUTGER STSaint Louis, MO 63104-1122
Mailing Address4028 Nw Claymont DrKansas City, MO 64116-1751 · (785) 562-6235
Phone(314) 977-7336
Sole ProprietorYes
Enumeration DateMay 11, 2023
Last NPPES UpdateJuly 22, 20262 updates tracked since enumeration
NPPES CertifiedJuly 22, 2026
✔ NPI 1033809181 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in MO · 2026026685
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
3320 RUTGER ST, Saint Louis, MO 63104
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ally Marie Gourley is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$69.50 typical visit price
range $17.76 – $137.92
Typical copayment $17.37 (range $4.44 – $34.48)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ST. LOUIS UNIVERSITY
Clinic/Center (Dental)
3320 RUTGER ST
SAINT LOUIS, MO 63104
St. Louis City (314) 977-8363
DR. TREY HENSLER DDS
Dentist
3320 RUTGER ST
SAINT LOUIS, MO 63104
St. Louis City (314) 977-8600
SAINT LOUIS UNIVERSITY
Clinic/Center (Dental)
3320 RUTGER ST
SAINT LOUIS, MO 63104
St. Louis City (314) 977-7336
AZADEH ESLAMI AMIN DDS
Dentist (Orthodontics and Dentofacial Orthopedics)
3320 RUTGER ST
SAINT LOUIS, MO 63104
St. Louis City (314) 977-8363
DR. LINDSAY ANNE POWERS D.M.D.
Dentist
3320 RUTGER ST
SAINT LOUIS, MO 63104
St. Louis City (314) 977-8381
DR. AVRUM GOLDBERG DDS
Student in an Organized Health Care Education/Training Program
3320 RUTGER ST
SAINT LOUIS, MO 63104
St. Louis City (314) 977-8363
DR. LINDSAY KATHLEEN GORMAN D.M.D.
Dentist
3320 RUTGER ST
SAINT LOUIS, MO 63104
St. Louis City (314) 977-8363
ANDREW MARTENS DMD
Dentist (Endodontics)
3320 RUTGER ST
SAINT LOUIS, MO 63104
St. Louis City (309) 507-2877

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ally Gourley's NPI number?

The NPI number for Ally Gourley is 1033809181. It was assigned to this individual provider in the NPPES registry on May 11, 2023.

Where is Ally Gourley located?

Ally Gourley practices at 3320 Rutger St, Saint Louis, MO 63104. The listed phone number is (314) 977-7336.

What is Ally Gourley's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Is Ally Gourley enrolled in Medicare?

Yes. Ally Gourley is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ally Gourley was last updated on July 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.