Individual provider Active NPI

Maryana Hilal, DMD

  • Dentist
  • Louisville, KY
National Provider Identifier
1417224619
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9867 Issued in TN
Practice address
2500 W Broadway
Louisville, KY 40211-1081
Phone
(502) 776-1754
NPI assigned
Nov 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9867 TN Primary
Dentist 122300000X 9117 KY

Addresses

Primary practice location

2500 W Broadway
Louisville, KY 40211-1081

Mailing address

2500 W Broadway
Louisville, KY 40211-1081
Phone (502) 776-1754

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20150713002415 TN Order and Referring Only - DentistPractitioner - Dentist 7012220544

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9867TNMDClinical Social Worker
9117KYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1417224619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402111081",
            "telephone_number": "502-776-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402111081",
            "telephone_number": "502-776-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILAL",
        "first_name": "MARYANA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-16",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "9867",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "9117",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.