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NPI Code Detail

MEDICARE: DR. LASHAUNDA L GILL D.D.S.

MEDICARE: DR. LASHAUNDA L GILL D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistDN123052GA
2122300000XDentistDEN1000244DC

General Provider Information

NPI Number : 1356558837
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LASHAUNDA L GILL D.D.S.
Provider Business Mailing Address
First Line : 320 M ST SW
Second Line :
City : WASHINGTON
State : DC
Zip : 20024-4002
Country : US
Telephone Number : 202-487-3981
Fax Number :
Provider Business Practice Location Address
First Line : 1600 FORT BENNING RD
Second Line :
City : COLUMBUS
State : GA
Zip : 31903-2834
Country : US
Telephone Number : 706-322-9599
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2007
Last Update Date : 11/01/2023

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