Provider Demographics
NPI:1285052100
Name:SUKHWINDER S. GILL DDS, INC.
Entity type:Organization
Organization Name:SUKHWINDER S. GILL DDS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUKHWINDER
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:661-854-3306
Mailing Address - Street 1:15019 OAKEN CROFT DR.
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93314
Mailing Address - Country:US
Mailing Address - Phone:661-836-0000
Mailing Address - Fax:661-836-0006
Practice Address - Street 1:505 BEAR MOUNTAIN BLVD. SUITE A
Practice Address - Street 2:
Practice Address - City:ARVIN
Practice Address - State:CA
Practice Address - Zip Code:93203-1454
Practice Address - Country:US
Practice Address - Phone:661-854-3306
Practice Address - Fax:661-854-3357
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUKHWINDER S. GILL DDS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-03-29
Last Update Date:2014-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA503731223G0001X, 261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1659382752Medicaid