Kwesi Gill, DDS
Individual provider Active NPI Pediatric Dentistry · Brandywine, MD
NPI 1902235211 · NPPES record last updated Dec 17, 2024
Key facts
- NPI
- 1902235211
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Dentistry 1223P0221X
- License
- 15329 (MD)
- Practice address
- 7704 Matapeake Business Dr Ste 155
Brandywine, MD 20613-3048 - Phone
- (718) 807-1943
- NPI assigned
- Nov 6, 2013
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15329 | MD | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kwesi Gill DDS LLC | Pediatric Dentistry | Past |
Accepting new patients |
Interoperability endpoints
- kgill824972@direct.umm.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 15329 | MD | |
| Pediatric Dentistry | 1223P0221X | 15329 | MD | Yes |
Addresses
Primary practice location
7704 Matapeake Business Dr Ste 155
Brandywine, MD 20613-3048
Mailing address
7704 Matapeake Business Dr Ste 155
Brandywine, MD 20613-3048
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All providers in Brandywine, MD · Pediatric Dentistry in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.