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DR. JEFFREY ALAN WILLIS DDS, MS
NPI 1164040044
Dentist - Prosthodontics in San Diego, CA

Active since July 08, 2020PECOS Enrolled
2310 CRAVEN ST, SAN DIEGO, CA 92136(619) 556-9095 Get Directions Write a Review

NPPES record last updated: November 4, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 4, 2025, Nov 30, 2022, Jul 8, 2020 (3 updates tracked since 2020).

About Dr. Jeffrey Alan Willis Dds, Ms NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JEFFREY ALAN WILLIS DDS, MS (NPI 1164040044) is an individual prosthodontics provider in San Diego, California, licensed in New York (1188483) and active in the NPI registry since July 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164040044
Entity TypeIndividualMale
Primary Taxonomy1223P0700X
Provider Legal NameDR. JEFFREY ALAN WILLISCredential: DDS, MS
Location Address2310 CRAVEN STSan Diego, CA 92136-5596
Mailing Address2310 Craven StSan Diego, CA 92136-5596
Phone(619) 556-9095
Sole ProprietorNo
Enumeration DateJuly 8, 2020
Last NPPES UpdateNovember 4, 20253 updates tracked since enumeration
NPPES CertifiedNovember 4, 2025
✔ NPI 1164040044 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · ProsthodonticsDental Providers
Taxonomy Code1223P0700X
License✔ Licensed in NY · 1188483
Definition
That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.
2310 CRAVEN ST, San Diego, CA 92136
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jeffrey Alan Willis Dds, Ms is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92136 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$76.87 typical visit price
range $20.62 – $151.42
Typical copayment $19.21 (range $5.15 – $37.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. WAYNE MICHAEL DEUTSCH DDS, MPH
Dentist (Dental Public Health)
2310 CRAVEN ST
SAN DIEGO, CA 92136
San Diego County (619) 556-8210
MRS. DESIREE ROSE GATBONTON RDH
Dental Hygienist
2310 CRAVEN ST
SAN DIEGO, CA 92136
San Diego County (619) 556-9984
DR. JESSE PAUL PORTER DDS
Dentist
2310 CRAVEN ST, NDMC 32ND ST. BLDG. 3230
SAN DIEGO, CA 92136
San Diego County (619) 556-1581
ALAN HSIANG-SHANG CHEN DDS
Dentist
2310 CRAVEN ST
SAN DIEGO, CA 92136
San Diego County (619) 556-9193
DR. ERIKA KULLBERG DMD
Dentist (General Practice)
2310 CRAVEN ST
SAN DIEGO, CA 92136
San Diego County (619) 556-8248
ANNA VEITZMAN D.D.S.
Dentist (General Practice)
2310 CRAVEN ST
SAN DIEGO, CA 92136
San Diego County (619) 556-8240
MARIA ELOISA ALMAZAR RDH
Dental Hygienist
2310 CRAVEN ST
SAN DIEGO, CA 92136
San Diego County (619) 556-8240
JAYNELL F FELIZARDO RDH
Dental Hygienist
2310 CRAVEN ST
SAN DIEGO, CA 92136
San Diego County (619) 556-8842

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeffrey Willis's NPI number?

The NPI number for Jeffrey Willis is 1164040044. It was assigned to this individual provider in the NPPES registry on July 8, 2020.

Where is Jeffrey Willis located?

Jeffrey Willis practices at 2310 Craven St, San Diego, CA 92136. The listed phone number is (619) 556-9095.

What is Jeffrey Willis's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Prosthodontics, with taxonomy code 1223P0700X.

Is Jeffrey Willis enrolled in Medicare?

Yes. Jeffrey Willis is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jeffrey Willis was last updated on November 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.