Provider Demographics
NPI:1639178577
Name:GILBERT, DELON K (DDS)
Entity Type:Individual
Prefix:DR
First Name:DELON
Middle Name:K
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 1:278 ROWE STREET
Mailing Address - Street 2:
Mailing Address - City:WHEELER
Mailing Address - State:OR
Mailing Address - Zip Code:97146-0000
Mailing Address - Country:US
Mailing Address - Phone:503-810-3840
Mailing Address - Fax:
Practice Address - Street 1:92210 WHISKEY LN
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:OR
Practice Address - Zip Code:97146-7204
Practice Address - Country:US
Practice Address - Phone:503-810-3840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2012-03-08
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
OR8055122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist