Simran Singh Gill, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

104535 Issued in CA

Practice address

110 Nut Tree Pkwy
Vacaville, CA 95687-3251

Phone

(707) 451-8390

NPI assigned

Nov 14, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Mantena and Ghazal Dental Corporation

  • General Practice Dentistry
  • Vacaville, CA
  • NPI 1043589294
  NPD (past)

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1922643899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 POLE LINE RD APT 35",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956180525",
            "telephone_number": "215-433-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 NUT TREE PKWY",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956873251",
            "telephone_number": "707-451-8390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "SIMRAN",
        "middle_name": "SINGH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-14",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE NUMBER",
            "identifier": "104535",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Soroush Ghaffarpour, DDS
• Mustafa Sadiq Ghassemi, LMFT
• Gianna C Lum DDS Inc
• Michael Alfonce Giarritta, MFT
• Kimberly Gill-Keating, PSY.D.
• Supria K. Gill, PHD
• Kyla Gish, LE
• Ashley Gisi
• Elizabeth Marie Gladney, AGACNP-BC
• Glenn S. Fung, DMD., Inc

• General Practice Dentistry in Vacaville, CA
• Providers in Vacaville, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; 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.