Lilia Gavrilov

Primary specialty

DentistTaxonomy code 122300000X

License

21493 Issued in MA

Practice address

4 Meeting Street
Chelmsford, MA 01824

Phone

(401) 996-5597

NPI assigned

Nov 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1164599494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MEETING STREET",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "01824",
            "telephone_number": "401-996-5597",
            "fax_number": "617-241-8168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MEETING STREET",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "01824",
            "telephone_number": "401-996-5597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVRILOV",
        "first_name": "LILIA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "21493",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "RI",
            "license": "DEN02650",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "DEN02650",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alden G Gagnon, M.D.
• Buffy Marie Gamache, LICSW
• Gopi Garala
• Vivian Garcia, MED
• Gail Marie Gardetto, LICSW
• Foryoung George-Fru, PTA
• Curtis George
• Paul Georges, DPM
• Abdul Ghaffar, M.D.
• Giac Dang DMD Inc

• Dentist in Chelmsford, MA
• Providers in Chelmsford, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.