Provider Demographics
NPI:1275947251
Name:GILBERT, JEFFREY HLUCHAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:HLUCHAN
Last Name:GILBERT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:438 S EMERSON AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1948
Mailing Address - Country:US
Mailing Address - Phone:317-886-7803
Mailing Address - Fax:
Practice Address - Street 1:438 S EMERSON AVE STE 230
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1948
Practice Address - Country:US
Practice Address - Phone:317-886-7803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9489122300000X
IN12012832A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist