Provider Demographics
NPI:1558901140
Name:GASKILL, JOSHUA ADAM (DDS)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ADAM
Last Name:GASKILL
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 1:91 CANYON GATE LN
Mailing Address - Street 2:
Mailing Address - City:SELAH
Mailing Address - State:WA
Mailing Address - Zip Code:98942-8954
Mailing Address - Country:US
Mailing Address - Phone:509-833-6051
Mailing Address - Fax:
Practice Address - Street 1:1300 N 1ST ST
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-1702
Practice Address - Country:US
Practice Address - Phone:509-248-4510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARR609559801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice