Brian Lee Cilla, DDS MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

290104700 Issued in MI

Practice address

3145 Prairie St SW
Suite 104
Grandville, MI 49418-2098

Phone

(616) 531-1920

Fax

(616) 531-4275

NPI assigned

Aug 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Credentials

Master of Science

State licenses

Practice roles

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.

• Brian Cilla DDS Ms PC

  • Periodontics
  • Grand Rapids, MI
  • NPI 1922266741
  NPD (past) Authorized official

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215046909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3145 PRAIRIE ST SW",
            "address_2": "SUITE 104",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182098",
            "telephone_number": "616-531-1920",
            "fax_number": "616-531-4275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3145 PRAIRIE ST SW",
            "address_2": "SUITE 104",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182098",
            "telephone_number": "616-531-1920",
            "fax_number": "616-531-4275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CILLA",
        "first_name": "BRIAN",
        "middle_name": "LEE",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "290104700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Grandville, MI
• Providers in Grandville, MI by specialty
• Periodontics in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.