Healthcare Provider Details

I. General information

NPI: 1134535073
Provider Name (Legal Business Name): MANBIR SINGH GILL DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2014
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16835 ALKALI DR STE M
LEMOORE CA
93245-9463
US

IV. Provider business mailing address

16835 ALKALI DR
LEMOORE CA
93245-9463
US

V. Phone/Fax

Practice location:
  • Phone: 559-924-0460
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number64310
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: