Jill Frazier, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

MT1944 Issued in MT

Practice address

715 Kensington Ave
Suite 1
Missoula, MT 59801-5769

Phone

(406) 549-6222

NPI assigned

Jul 31, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Jill Gama Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229731200000",
    "number": "1710177233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 KENSINGTON AVE",
            "address_2": "SUITE 1",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598015769",
            "telephone_number": "406-549-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 KENSINGTON AVE",
            "address_2": "SUITE 1",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598015769",
            "telephone_number": "406-549-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZIER",
        "first_name": "JILL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-31",
        "last_updated": "2008-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "MT1944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005511179",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "GAMA",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• General Practice Dentistry in Missoula, MT
• Providers in Missoula, MT by specialty
• General Practice Dentistry in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.