Provider Demographics
NPI:1346990728
Name:GILL, SAVREEN
Entity Type:Individual
Prefix:
First Name:SAVREEN
Middle Name:
Last Name:GILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6310 SHIPLETT BLVD
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-3443
Mailing Address - Country:US
Mailing Address - Phone:571-480-1305
Mailing Address - Fax:
Practice Address - Street 1:1701 CLARENDON BLVD STE 250B
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22209-4800
Practice Address - Country:US
Practice Address - Phone:703-636-7878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2023-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17550122300000X
VA0401418321122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist