Provider Demographics
NPI:1447228523
Name:GILBERT, DAVID H (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:H
Last Name:GILBERT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 E FOOTHILL BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4052
Mailing Address - Country:US
Mailing Address - Phone:909-982-8888
Mailing Address - Fax:909-982-8251
Practice Address - Street 1:1333 E FOOTHILL BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4052
Practice Address - Country:US
Practice Address - Phone:909-982-8888
Practice Address - Fax:909-982-8251
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA426541223S0112X, 204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACK153ZMedicare PIN