Active NPI
Mia Jonelle Tittle, DDS
- Endodontics
- Pleasant Hill, CA
National Provider Identifier
1447902226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DDS104244
- Practice address
- 401 Gregory LN Ste 118
Pleasant Hill, CA 94523-2851 - Phone
- (925) 676-3388
- NPI assigned
- Jan 22, 2022
- Last updated
- Jan 22, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DDS104244 | CA | Primary |
Addresses
Primary practice location
401 Gregory LN Ste 118
Pleasant Hill, CA 94523-2851
Mailing address
5402 Stonehurst Dr
Martinez, CA 94553-9725
Phone (925) 822-2491
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS104244 | CA | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642809600000",
"number": "1447902226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5402 STONEHURST DR",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "945539725",
"telephone_number": "925-822-2491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 GREGORY LN STE 118",
"city": "PLEASANT HILL",
"state": "CA",
"postal_code": "945232851",
"telephone_number": "925-676-3388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TITTLE",
"first_name": "MIA",
"middle_name": "JONELLE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-22",
"last_updated": "2022-01-22",
"certification_date": "2022-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CA",
"license": "DDS104244",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pleasant Hill, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.