Individual provider Active NPI

Janetta Basalilov, DDS

  • General Practice Dentistry
  • Forest Hills, NY
National Provider Identifier
1184301723
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
064862 Issued in NY
Practice address
6836 108TH St Apt A14
Forest Hills, NY 11375-3348
Phone
(347) 439-7770
NPI assigned
Jul 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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 064862 NY Primary

Addresses

Primary practice location

6836 108TH St Apt A14
Forest Hills, NY 11375-3348

Mailing address

6836 108TH St Apt A14
Forest Hills, NY 11375-3348
Phone (347) 439-7770

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
064862NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1688428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1184301723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6836 108TH ST APT A14",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753348",
            "telephone_number": "347-439-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6836 108TH ST APT A14",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753348",
            "telephone_number": "347-439-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASALILOV",
        "first_name": "JANETTA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-04",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "064862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; 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.