C.G. Ghazal and a.K. Gill Dental Corporation

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

C.G. GHAZAL AND A.K. GILL DENTAL CORPORATION

Doing business as

Clovis Crossing Dental Group

Practice address

1095 Herndon Ave
102
Clovis, CA 93612-0504

Phone

(559) 326-5270

Fax

(559) 326-5271

NPI assigned

Mar 3, 2014

Last updated

Mar 3, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Carolyn G Ghazal, DDS

Title

Owner Doctor

Phone

(559) 326-5270

Specialties & licenses 1

Addresses

Other names 1

• Clovis Crossing Dental Group Doing business as

Locations

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

{
    "created_epoch": "1393804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393804800000",
    "number": "1346665122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 HERNDON AVE",
            "address_2": "102",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936120504",
            "telephone_number": "559-326-5270",
            "fax_number": "559-326-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C.G. GHAZAL AND A.K. GILL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-03",
        "last_updated": "2014-03-03",
        "status": "A",
        "authorized_official_last_name": "GHAZAL",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "559-326-5270",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clovis Crossing Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Burdeshaw
• Julia Butler, PHD
• Autumn Clare Bradley Byers, LCSW
• David Christopher Byers, MS
• Chelsee Bznuni, ABA
• Lorraine Esther Caballero
• Brinsley Michelle Cabezut
• Edilberto Cabral
• Amy Alexis Cadenazzi, LCSW
• Keba Cage, COTA

• Dentist in Clovis, CA
• Providers in Clovis, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; 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.