NPIMap

Organization Active NPI

Dental Corporation of Amardeep Gill DDS

Doing business as South River Dental Group

  • General Practice Dentistry
  • West Sacramento, CA
National Provider Identifier
1184874026
Registry record updated Nov 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL CORPORATION OF AMARDEEP GILL DDS
Doing business as
South River Dental Group
Practice address
2455 Jefferson Blvd
Suite 130
West Sacramento, CA 95691
Phone
(916) 372-8062
Fax
(916) 371-1863
NPI assigned
Sep 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Amardeep Gill
Title
Owner
Phone
(916) 372-8062

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2455 Jefferson Blvd
Suite 130
West Sacramento, CA 95691

Mailing address

2860 Michelle
2ND Floor
Irvine, CA 92606-1009
Phone (714) 368-2077

Other names 1

  • South River Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

2455 Jefferson Blvd
Ste 130
West Sacramento, CA 95691
Phone (916) 372-8062

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384214400000",
    "number": "1184874026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 MICHELLE",
            "address_2": "2ND FLOOR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061009",
            "telephone_number": "714-368-2077",
            "fax_number": "714-368-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 JEFFERSON BLVD",
            "address_2": "SUITE 130",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "95691",
            "telephone_number": "916-372-8062",
            "fax_number": "916-371-1863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL CORPORATION OF AMARDEEP GILL DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-29",
        "last_updated": "2013-11-12",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "AMARDEEP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-372-8062",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South River Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.