Healthcare Provider Details

I. General information

NPI: 1447228523
Provider Name (Legal Business Name): DAVID H. GILBERT D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 08/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1333 E FOOTHILL BLVD SUITE 1
UPLAND CA
91786-4052
US

IV. Provider business mailing address

1333 E FOOTHILL BLVD SUITE 1
UPLAND CA
91786-4052
US

V. Phone/Fax

Practice location:
  • Phone: 909-982-8888
  • Fax: 909-982-8251
Mailing address:
  • Phone: 909-982-8888
  • Fax: 909-982-8251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number42654
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number42654
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: