Lily Dental PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

LILY DENTAL PC

Practice address

837 59TH St FL 3
Brooklyn, NY 11220-5577

Phone

(718) 576-1558

NPI assigned

Mar 23, 2022

Last updated

Sep 26, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Yunbo SongNPI 1154759165

Title

President

Phone

(718) 576-1558

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Yunbo Song, DMD

  • Dentist
  • Manville, NJ
  • NPI 1154759165
  NPD Authorized official

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

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1598415655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "837 59TH ST FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112205577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 59TH ST FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112205577",
            "telephone_number": "718-576-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILY DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-23",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "YUNBO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-576-1558"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05703168",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roy Carroll Lilly Jr., PHARM.D., R.PH.
• Michael Lilov
• Chaya Mushka Lilove
• Yehezkel Lilu, PH.D.
• Lily Boyar
• Lily Louis Corporation (Nathan's Pharmacy)
• Lilycare of Colorado LLC
• Lilycare of Delaware LLC
• Lilycare of Maine LLC (Lilycare of Maine)
• Lilycare of Pennslyvania LLC

• Dentist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.