Dr. Paul Ilan

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DR. PAUL ILAN

Practice address

14930 88TH St
Howard Beach, NY 11414-1463

Phone

(718) 843-3222

Fax

(718) 843-4716

NPI assigned

Apr 2, 2022

Last updated

Apr 2, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Krystal Garcia

Title

Manager

Phone

(718) 843-3222

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1648857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648857600000",
    "number": "1063153336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14930 88TH ST",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114141463",
            "telephone_number": "718-843-3222",
            "fax_number": "718-843-4716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14930 88TH ST",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114141463",
            "telephone_number": "718-843-3222",
            "fax_number": "718-843-4716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. PAUL ILAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-02",
        "last_updated": "2022-04-02",
        "certification_date": "2022-04-02",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-843-3222"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.