Individual provider Active NPI

Lilia Cucerov, D.M.D.

  • General Practice Dentistry
  • Roslindale, MA
National Provider Identifier
1144549155
Registry record updated Jun 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN1855390 Issued in MA
Practice address
644 American Legion Hwy
Roslindale, MA 02131-3901
Phone
(617) 390-7090
NPI assigned
Jun 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN1855390 MA Primary

Addresses

Primary practice location

644 American Legion Hwy
Roslindale, MA 02131-3901

Mailing address

8 Mount Ida St Apt 4
Newton, MA 02458-1986
Phone (617) 467-5205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN1855390MAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1275350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275350400000",
    "number": "1144549155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 MOUNT IDA ST APT 4",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024581986",
            "telephone_number": "617-467-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "644 AMERICAN LEGION HWY",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021313901",
            "telephone_number": "617-390-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUCEROV",
        "first_name": "LILIA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-01",
        "last_updated": "2010-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1855390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslindale, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2010; 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.