Jonathan Taft Gille, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

108777 Issued in CA

Practice address

5638 Mission Center Rd Ste 107
San Diego, CA 92108-4348

Phone

(619) 220-0159

NPI assigned

May 15, 2023

Last updated

May 15, 2023By the provider in NPPES

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lance Rygg Professional Dental Corporation

  dba Mission Valley Dentists

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1366701096
  NPD (past)

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1982395646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3042 MASTERS PL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921233237",
            "telephone_number": "727-504-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5638 MISSION CENTER RD STE 107",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084348",
            "telephone_number": "619-220-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLE",
        "first_name": "JONATHAN",
        "middle_name": "TAFT",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheenah Gill, BCBA
• Tajinder H Gill
• Todd Gill, PT
• Vikram Singh Gill, MD
• Christina Gille, M.A.
• Maureen Gillen, OTR/L
• Thomas Engel Gillen, M.D.
• Ashley Giller, OTR/L
• Louis George Gilleran, M.D.
• Alissa J Gilles, MD

• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.