Healthcare Provider Details

I. General information

NPI: 1336986884
Provider Name (Legal Business Name): SARA GILBERT DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2024
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 SAINT ANTHONY AVE
SAINT PAUL MN
55104-4006
US

IV. Provider business mailing address

1375 SAINT ANTHONY AVE
SAINT PAUL MN
55104-4006
US

V. Phone/Fax

Practice location:
  • Phone: 651-645-4671
  • Fax: 651-646-1342
Mailing address:
  • Phone: 651-645-4671
  • Fax: 651-646-1342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD15086
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: