Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. John Malcolm Gillis, DMD

Individual provider Oral and Maxillofacial Surgery (Dentist) · NPI 1083673610

Dr. John Malcolm Gillis, DMD is an Oral Surgery in Phoenix, Arizona. Graduated from University of Mississippi School of Medicine in 2000, 26 years ago. Practices with Banner - University Physician Specialists LLC, a 347-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
26
Trained at
University of Mississippi School of Medicine
Licensed in
AZ
In the registry since
2006
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

1441 N 12th St Fl 23
Phoenix, AZ 85006-2837
Phone: (602) 521-5150
Fax: (602) 521-5151
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 6147 (AZ)

Record details

NPI number1083673610
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedMarch 22, 2006
Last updated in NPPESJanuary 17, 2022
Certification dateJanuary 17, 2022
Mailing address1111 E McDowell Rd, Phoenix, AZ 85006-2612

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyORAL SURGERY
Also practisesMAXILLOFACIAL SURGERY
Medical schoolUNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Graduated 2000 (26 years in practice)
Group practice Banner - University Physician Specialists Llc — 347 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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