=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912884685
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DR. GILL & ASSOCIATES, PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/16/2025
-----------------------------------------------------
Last Update Date | 12/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2761 NC HIGHWAY 210 E STE C
-----------------------------------------------------
City | HAMPSTEAD
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28443-8956
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-530-1370
-----------------------------------------------------
Fax | 910-530-1232
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5640 DILLARD DR STE 101
-----------------------------------------------------
City | CARY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27518-7174
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. AMANDA GILL
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 910-530-1370
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332BC3200X
-----------------------------------------------------
Taxonomy Name | Customized Equipment (DME)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------