Provider Demographics
NPI:1447469762
Name:SELKIN, GILBERT TREMAYNE (MD, DMD)
Entity type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:TREMAYNE
Last Name:SELKIN
Suffix:
Gender:M
Credentials:MD, DMD
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Mailing Address - Street 1:12700 PARK CENTRAL DR STE 1210
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-1522
Mailing Address - Country:US
Mailing Address - Phone:214-987-3376
Mailing Address - Fax:469-532-0273
Practice Address - Street 1:5060 TENNYSON PKWY STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-4170
Practice Address - Country:US
Practice Address - Phone:214-556-5695
Practice Address - Fax:469-609-2962
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX215861223S0112X
TXN1443204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXOTH020Medicare UPIN