Provider Demographics
NPI:1578153623
Name:GILL, SUKHMANI KAUR (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUKHMANI
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 1:9427 PALLADIUM HTS APT 115
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-1601
Mailing Address - Country:US
Mailing Address - Phone:720-725-1997
Mailing Address - Fax:
Practice Address - Street 1:8008 WALERGA RD STE 100
Practice Address - Street 2:
Practice Address - City:ANTELOPE
Practice Address - State:CA
Practice Address - Zip Code:95843-9003
Practice Address - Country:US
Practice Address - Phone:916-725-4530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-22
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002046301223G0001X
CADDS108609122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty