Healthcare Provider Details

I. General information

NPI: 1821775354
Provider Name (Legal Business Name): ANNA REBECCA GILBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

272 FRANKLIN AVE
HARTFORD CT
06114-1848
US

IV. Provider business mailing address

272 FRANKLIN AVE
HARTFORD CT
06114-1848
US

V. Phone/Fax

Practice location:
  • Phone: 860-257-4000
  • Fax:
Mailing address:
  • Phone: 860-257-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number14553
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: