DR. JOHN MALCOLM GILLIS (NPI# 1083673610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083673610 |
| Entity Type | Individual |
| Full Name | DR. JOHN MALCOLM GILLIS |
| Credential | DMD |
| Practice Address |
4102 Pinion Dr Usaf Academy CO 80840-2502 |
| Practice Telephone | 4809074822 |
| Practice Fax Number | 4809074822 |
| Mailing Telephone | 4809074822 |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2018-03-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
6147 | AZ | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 931982 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083970628 | John Francis Gillis II | Ophthalmology | 88 Mdg/sghj 4881 Sugar Maple Dr, Bldg 830, Wright Patterson Afb, OH 45433-5529 | 2012-04-09 |
| 1154459469 | John P Gillis | Dentist | 5037 Veterans Blvd. Suite 1, Suite 1, Metairie, LA 70006 | 2007-02-28 |
| 1770623480 | John E. Gillis | Dentist | 15810 S 45th St Ste 120, Phoenix, AZ 85048-7695 | 2007-02-08 |
| 1710965769 | John Charles Gillis | Dentist | 68 Old Airport Rd, Hattiesburg, MS 39401-8382 | 2006-01-09 |
| 1962749143 | John F Gillis | Pharmacist | 19390 Cortez Blvd, Brooksville, FL 34601-3041 | 2013-01-09 |
| 1679646822 | John Allen Gillis | Chiropractor | 1905 Latham Ave, Lima, OH 45805-1637 | 2006-11-16 |
| 1538231774 | John Mcnatt Gillis | Family Medicine | 2211 E Northern Lights Blvd, Anchorage, AK 99508-4103 | 2006-11-14 |
| 1902898513 | John F Gillis | Ophthalmology | 185 Joe Knox Ave, Mooresville, NC 28117-9169 | 2005-08-19 |
| 1740288935 | John Andrew Gillis | Physical Therapist | 5530 Wisconsin Ave, Suite 604, Chevy Chase, MD 20815-4404 | 2005-07-12 |
| Street Address |
4102 PINION DR |
| City | USAF ACADEMY |
| State | CO |
| Zip Code | 80840-2502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336776467 | Rebecca Briones | Student in an Organized Health Care Education/Training Program | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2020-03-26 |
| 1588222129 | Christopher J Drager | Physical Therapist | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2019-05-29 |
| 1346706454 | Hannah M Szilagy | Physical Therapist | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2019-02-13 |
| 1831671262 | Alexander Ortiz | Physician Assistant | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2018-09-01 |
| 1336629096 | Kim D Tran | Family Medicine | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2018-08-21 |
| 1235624065 | Lauren Yurish-crittenden | Psychologist | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2018-06-25 |
| 1477055572 | Keeley Katrein | Physician Assistant | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2018-03-05 |
| 1588162176 | Justin James Fleming | Physical Therapy Assistant | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2018-01-29 |
| 1609392570 | Mark Eulenstein | Dentist | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2017-08-22 |
| 1306387436 | Carrie Marie Ferguson | Nurse Practitioner | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2017-03-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114554011 | Christina Dang | Student in an Organized Health Care Education/Training Program | 4355-b Faculty Drive, Us Air Force Academy, CO 80840 | 2020-03-23 |
| 1053893123 | Glen William Myers | Dentist | 2355-b Faculty Dr, Usaf Academy, Colorado, Usafa, AA 80840 | 2018-09-05 |
| 1225374499 | National Vision Optical | Technician/Technologist | Bldg 5136, Community Center Dr., Us Air Force Academy, CO 80840 | 2012-12-17 |
| 1366758906 | Brett Michael Germain | Dentist | 2355-b Faculty Dr., Usaf Academy, CO 80840 | 2010-08-20 |
| 1518289115 | Renee Jean Cole | Military Health Care Provider | 4515 East Juniper Dr Unit A, Usaf Academy, CO 80840 | 2010-02-23 |
| 1063655140 | Gregory S. Brooks | Military Health Care Provider | 2355 Faculty Dr Suite 1n207, 10th Amds, Usafa, CO 80840 | 2009-04-20 |
| 1801092390 | Bryant Mcneill | Internal Medicine | 4102 Pinion 10mdg, Usaf Academy, CO 80840 | 2007-06-22 |
| 1447384383 | Francis Crosby Jr. | Physician Assistant | 4102 Pinon Drive, Usaf Academy, CO 80840 | 2007-03-15 |
| 1023115870 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 5136 Eagle Dr, Ste 102, Usaf Academy, CO 80840 | 2006-09-20 |
| 1669582722 | Scott Layle Carbaugh | Physician Assistant | 4102 Pinion Dirve, Usaf Academy, CO 80840 | 2006-08-30 |
| Find all providers in zip 80840 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548323892 | Trent Wayne Listello | Dentist | 4102 Pinion Dr, 10 Mdg, Usaf Academy, CO 80840-2502 | 2006-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669071189 | Oms Associates Colorado PC | Dentist | 755 Maleta Ln Ste A, Castle Rock, CO 80108-7610 | 2020-10-26 |
| 1346849866 | Oms Associates Colorado PC | Dentist | 1755 Telstar Dr Ste 210, Colorado Springs, CO 80920-1018 | 2020-10-26 |
| 1740889260 | Oms Associates Colorado PC | Dentist | 10219 Parkglenn Way Ste 201, Parker, CO 80138-3875 | 2020-10-26 |
| 1386266070 | Blue Sky Oms P.C. | Dentist | 1707 61st Ave Ste 102, Greeley, CO 80634-7997 | 2020-05-15 |
| 1679121404 | James W Makowski Dds PC | Dentist | 1220 S Parker Rd Ste 104, Denver, CO 80231-2166 | 2019-08-26 |
| 1528553070 | Comfort Dental Oral Surgery Colorado Springs LLC | Dentist | 556 W. Hwy 105, Monument, CO 80132 | 2018-06-27 |
| 1689167280 | Cheyenne Mountain Oral Surgery PC | Dentist | 640 Southpointe Ct Ste 150, Colorado Springs, CO 80906-3884 | 2018-06-08 |
| 1932692589 | Glendale Oral Surgery PC | Dentist | 3955 E Exposition Ave Ste 520, Denver, CO 80209-5030 | 2018-06-08 |
| 1790292431 | Alix Greenman | Dentist | 6179 S Balsam Way Ste 100, Littleton, CO 80123-3092 | 2018-01-03 |
| 1467967307 | Boulder Oral Surgery | Dentist | 3450 Penrose Pl Ste 120, Boulder, CO 80301-1800 | 2017-12-13 |
| Find all providers with the same taxonomy | ||||
| City | USAF ACADEMY |
| Zip Code | 80840 |
Please comment or provide details below to improve the information on DR. JOHN MALCOLM GILLIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.