Active NPI
Marko Ilich, DDS
- General Practice Dentistry
- Palmyra, VA
National Provider Identifier
1669166237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0401418481
- Practice address
- 32 Garden LN
Palmyra, VA 22963-4282 - Phone
- (434) 510-7261
- NPI assigned
- Jun 6, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401418481 | VA | Primary |
Addresses
Primary practice location
32 Garden LN
Palmyra, VA 22963-4282
Mailing address
32 Garden LN
Palmyra, VA 22963-4282
Phone (434) 510-7261
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0401418481 | VA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dentistry at Nahor | General Practice | Current | Accepting new patients |
| Smiles With Joy | General Practice | Past | Accepting new patients |
| Caring Dentistry VA | General Practice | Past | Accepting new patients |
Locations
32 Garden Ln
Palmyra, VA 22963
Phone (434) 510-7261
Organizations & group practices 3
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753056000000",
"number": "1669166237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32 GARDEN LN",
"city": "PALMYRA",
"state": "VA",
"postal_code": "229634282",
"telephone_number": "434-510-7261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32 GARDEN LN",
"city": "PALMYRA",
"state": "VA",
"postal_code": "229634282",
"telephone_number": "434-510-7261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ILICH",
"first_name": "MARKO",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-06",
"last_updated": "2025-07-21",
"certification_date": "2025-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "VA",
"license": "0401418481",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palmyra, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.