Provider Demographics
NPI:1720836968
Name:MONEGAIN, JAMILLA (DDS)
Entity type:Individual
Prefix:
First Name:JAMILLA
Middle Name:
Last Name:MONEGAIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 N AZALEA WAY
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-1572
Mailing Address - Country:US
Mailing Address - Phone:626-650-1697
Mailing Address - Fax:
Practice Address - Street 1:924 N AZALEA WAY
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-1572
Practice Address - Country:US
Practice Address - Phone:626-650-1697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program