Individual provider Active NPI

Prabhdeep Kaur Gill, DDS

  • General Practice Dentistry
  • Fresno, CA
National Provider Identifier
1811225386
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
58656 Issued in CA
Practice address
7215 N 1St St Ste 107
Fresno, CA 93720-2985
Phone
(559) 229-2288
Fax
(559) 229-2287
NPI assigned
Nov 22, 2009
Last updated
Dec 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 58656 CA
General Practice Dentistry 1223G0001X 58656 CA Primary

Addresses

Primary practice location

7215 N 1St St Ste 107
Fresno, CA 93720-2985

Mailing address

7215 N 1St St Ste 107
Fresno, CA 93720-2985
Phone (559) 229-2288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130103000136 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4789837584

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
58656CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Prabhdeep K Gill DDS Inc CurrentSince Sep 17, 2023 Accepting new patients
Clinica Sierra Vista Past Accepting new patients
Sequoia Community Health Foundation,Inc. General Practice Past Accepting new patients

Locations

7215 N 1st St
Ste 107
Fresno, CA 93720
Phone (559) 229-2288

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1258848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1811225386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7215 N 1ST ST STE 107",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202985",
            "telephone_number": "559-229-2288",
            "fax_number": "559-229-2287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7215 N 1ST ST STE 107",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202985",
            "telephone_number": "559-229-2288",
            "fax_number": "559-229-2287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "PRABHDEEP",
        "middle_name": "KAUR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-22",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "58656",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.