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DR. JERRY A GWILLIAM DDS NPI 1265658751


NPI Profile

NPI: 1265658751
Provider Name: DR. JERRY A GWILLIAM, DDS
Classification:Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

Address:
1874 BONANZA ST
WALNUT CREEK, CA
ZIP 94596
Get Directions

Phone: (925) 935-6080

DR. Jerry A Gwilliam, DDS is a general practice dentist in Walnut Creek, CA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Jerry A Gwilliam, DDS NPI is 1265658751. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1874 BONANZA ST
WALNUT CREEK, CA
ZIP 94596-318
Phone: (925) 935-6080
Fax: (925) 935-6084

The enumeration date for this NPI number is 4/17/2007 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice18557CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1B18557-01MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/11/2021

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