Individual provider Active NPI

Igor Bilov

  • Dentist
  • North Port, FL
National Provider Identifier
1710430079
Registry record updated Aug 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN22108 Issued in FL
Practice address
1541 Gerona Ter
North Port, FL 34286-4962
Phone
(561) 376-0777
NPI assigned
Aug 3, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN22108 FL Primary

Addresses

Primary practice location

1541 Gerona Ter
North Port, FL 34286-4962

Mailing address

1541 Gerona Ter
North Port, FL 34286-4962

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
DN22108FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470182400000",
    "number": "1710430079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 GERONA TER",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342864962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 GERONA TER",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342864962",
            "telephone_number": "561-376-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILOV",
        "first_name": "IGOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-03",
        "last_updated": "2016-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN22108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Port, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; 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.