Brent Leslie Gilliland, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13335 Issued in TX

Practice address

12TH Aeromedical-Dental Squadron
221 3Rd Street West
Randolph Afb, TX 78150-4801

Phone

(210) 652-1846

Fax

(210) 652-1368

NPI assigned

Sep 8, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1902890676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 THOREAU TRL",
            "city": "SCHERTZ",
            "state": "TX",
            "postal_code": "781541158",
            "telephone_number": "210-845-1387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12TH AEROMEDICAL-DENTAL SQUADRON",
            "address_2": "221 3RD STREET WEST",
            "city": "RANDOLPH AFB",
            "state": "TX",
            "postal_code": "781504801",
            "telephone_number": "210-652-1846",
            "fax_number": "210-652-1368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLILAND",
        "first_name": "BRENT",
        "middle_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "13335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Christian Davis, D.D.S.
• Heather Fenzl, PHARM D
• Adrienne N Fields, ACNP-BC
• Zelwyn Zadiel Figueroa Bravo, PA-C
• Jon Paul Fitzgerald, IDMT
• Kathy Lynn Hagerman, CPNP
• Neema Rukiya Hardeman, M.D.
• Karen Holmstead, APRN
• Todd R. Howell, M.D.
• Camyla Madeline Sarah Joule

• General Practice Dentistry in Randolph Afb, TX
• Providers in Randolph Afb, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.