Provider Demographics
NPI:1043443146
Name:GILL, LUCKWINDER K (DDS)
Entity Type:Individual
Prefix:
First Name:LUCKWINDER
Middle Name:K
Last Name:GILL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:LUCKWINDER
Other - Middle Name:K
Other - Last Name:BRAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6949 185TH ST APT 2B
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-3544
Mailing Address - Country:US
Mailing Address - Phone:917-349-4086
Mailing Address - Fax:
Practice Address - Street 1:3721 75TH ST STE 1
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6405
Practice Address - Country:US
Practice Address - Phone:929-526-7229
Practice Address - Fax:212-414-4434
Is Sole Proprietor?:No
Enumeration Date:2009-08-24
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053218-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice