Healthcare Provider Details

I. General information

NPI: 1912884685
Provider Name (Legal Business Name): DR. GILL & ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2761 NC HIGHWAY 210 E STE C
HAMPSTEAD NC
28443-8956
US

IV. Provider business mailing address

5640 DILLARD DR STE 101
CARY NC
27518-7174
US

V. Phone/Fax

Practice location:
  • Phone: 910-530-1370
  • Fax: 910-530-1232
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. AMANDA GILL
Title or Position: PRESIDENT
Credential: DMD
Phone: 910-530-1370