NPIMap

Organization Active NPI

Gill Professional Dental Corporation

Doing business as Promenade Dental Group

  • General Practice Dentistry
  • Sacramento, CA
National Provider Identifier
1417120700
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GILL PROFESSIONAL DENTAL CORPORATION
Doing business as
Promenade Dental Group
Practice address
3635 North Freway Blvd
Suite 110
Sacramento, CA 95834
Phone
(916) 285-6691
Fax
(916) 575-9783
NPI assigned
Apr 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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

Authorized official

Name
Dr. Amardeep Gill, DDS
Title
Owner Doctor
Phone
(916) 285-6691

Specialties & licenses 1

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

Addresses

Primary practice location

3635 North Freway Blvd
Suite 110
Sacramento, CA 95834

Mailing address

2860 Michelle Drive
2ND Floor
Irvine, CA 92606-1009
Phone (714) 845-8890

Other names 1

  • PROMENADE DENTAL GROUP Doing business as

National Provider Directory

National Provider Directory

Locations

3635 N Freeway Blvd
Ste 110
Sacramento, CA 95834
Phone (916) 285-6691

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376352000000",
    "number": "1417120700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 MICHELLE DRIVE",
            "address_2": "2ND FLOOR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061009",
            "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": "3635 NORTH FREWAY BLVD",
            "address_2": "SUITE 110",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95834",
            "telephone_number": "916-285-6691",
            "fax_number": "916-575-9783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GILL PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2013-08-13",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "AMARDEEP",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "916-285-6691",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "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": "PROMENADE DENTAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.