DR. BRENT LESLIE GILLILAND D.D.S. NPI 1902890676

NPI Information

  • NPI: 1902890676
  • Provider Name: DR. BRENT LESLIE GILLILAND, D.D.S.
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Individual
  • Address: 12TH AEROMEDICAL-DENTAL SQUADRON
    221 3RD STREET WEST
    RANDOLPH AFB, TX
    ZIP 78150
  • Phone: (210) 652-1846

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NPI Details

DR. Brent Leslie Gilliland, D.D.S. is a general practice dentist in Randolph Afb, TX. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Brent Leslie Gilliland, D.D.S. NPI is 1902890676. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

12TH AEROMEDICAL-DENTAL SQUADRON
221 3RD STREET WEST
RANDOLPH AFB, TX
ZIP 78150-801
Phone: (210) 652-1846
Fax: (210) 652-1368

The enumeration date for this NPI number is 9/8/2005 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice13335TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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