Healthcare Provider Details

I. General information

NPI: 1487491718
Provider Name (Legal Business Name): GURVEEN GILL DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2024
Last Update Date: 08/30/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3452 ANDERSON HWY STE A
POWHATAN VA
23139-5845
US

IV. Provider business mailing address

3452 ANDERSON HWY STE A
POWHATAN VA
23139-5845
US

V. Phone/Fax

Practice location:
  • Phone: 209-302-0635
  • Fax:
Mailing address:
  • Phone: 209-302-0635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X2210X
TaxonomyOrofacial Pain Dentistry
License Number0401418532
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: