Individual provider Active NPI

Joshua D. Ilan

  • General Practice Dentistry
  • Pomona, NY
National Provider Identifier
1124141932
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
051103-1 Issued in NY
Practice address
18 Thiells Mount Ivy Rd
Suite 1
Pomona, NY 10970-3020
Phone
(845) 354-6444
Fax
(845) 354-9189
NPI assigned
Apr 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 051103-1 NY
General Practice Dentistry 1223G0001X 051103-1 NY Primary

Addresses

Primary practice location

18 Thiells Mount Ivy Rd
Suite 1
Pomona, NY 10970-3020

Mailing address

18 Thiells Mount Ivy Rd
Suite 1
Pomona, NY 10970-3020
Phone (845) 354-6444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150629001773 NY Order and Referring Only - DentistPractitioner - Dentist 6800108283

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
051103-1NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Family Dental, P.C. General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1124141932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 THIELLS MOUNT IVY RD",
            "address_2": "SUITE 1",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109703020",
            "telephone_number": "845-354-6444",
            "fax_number": "845-354-9189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 THIELLS MOUNT IVY RD",
            "address_2": "SUITE 1",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109703020",
            "telephone_number": "845-354-6444",
            "fax_number": "845-354-9189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILAN",
        "first_name": "JOSHUA",
        "middle_name": "D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-08",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "051103-1",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "051103-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, NY

Sources for this page

Verify at the official NPI Registry.