Individual provider Active NPI

Bilal Damlaj, DMD, CAGS, MSD

  • Endodontics
  • Cicero, NY
National Provider Identifier
1154701209
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
058720 Issued in NY
Practice address
8057 Brewerton Rd
Cicero, NY 13039-9585
Phone
(347) 400-9853
NPI assigned
Jun 4, 2015
Last updated
Aug 27, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 058720 NY
Endodontics 1223E0200X 058720 NY Primary

Addresses

Primary practice location

8057 Brewerton Rd
Cicero, NY 13039-9585

Mailing address

829 N Salina St Apt 31
Syracuse, NY 13208-2672
Phone (347) 400-9853

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
I20161107000168 NY Order and Referring Only - DentistPractitioner - Dentist 4688952047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1154701209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 N SALINA ST APT 31",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132082672",
            "telephone_number": "347-400-9853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8057 BREWERTON RD",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "130399585",
            "telephone_number": "347-400-9853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMLAJ",
        "first_name": "BILAL",
        "name_prefix": "Dr.",
        "credential": "DMD, CAGS, MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-04",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "058720",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "058720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cicero, NY

Sources for this page

Verify at the official NPI Registry.