Provider Demographics
NPI:1801951074
Name:GILBERT, SHAWN D (DDS)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:D
Last Name:GILBERT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 E BELL RD
Mailing Address - Street 2:STE 104
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-6640
Mailing Address - Country:US
Mailing Address - Phone:602-482-7000
Mailing Address - Fax:602-482-7021
Practice Address - Street 1:706 E BELL RD
Practice Address - Street 2:STE 106
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-6640
Practice Address - Country:US
Practice Address - Phone:602-404-3800
Practice Address - Fax:602-404-3757
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ55551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice