Provider Demographics
NPI:1073966743
Name:GILL, NAVJOT KAUR (DDS)
Entity Type:Individual
Prefix:
First Name:NAVJOT
Middle Name:KAUR
Last Name:GILL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15051 HESPERIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-3536
Mailing Address - Country:US
Mailing Address - Phone:510-481-2487
Mailing Address - Fax:
Practice Address - Street 1:15051 HESPERIAN BLVD
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-3536
Practice Address - Country:US
Practice Address - Phone:510-481-2487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-19
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100460122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice