Individual provider Active NPI

Elen Kirilovski, DMD

  • Dentist
  • Bronx, NY
National Provider Identifier
1730742362
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.025969 Issued in OH
Practice address
234 E 149TH St Dept of
Bronx, NY 10451-5504
Phone
(718) 579-5691
NPI assigned
Apr 18, 2019
Last updated
Feb 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.025969 OH Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

234 E 149TH St Dept of
Bronx, NY 10451-5504

Mailing address

9500 Mentor Ave
Mentor, OH 44060-8713

Other practice location 1

234 E. 149th St.
Department of Dentistry Clinic 2A8
Bronx, NY 10451-1045
Phone (718) 579-5691

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1730742362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440608713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST DEPT OF",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515504",
            "telephone_number": "718-579-5691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "234 E. 149th St.",
            "address_2": "Department of Dentistry Clinic 2A8",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104511045",
            "country_code": "US",
            "telephone_number": "718-579-5691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRILOVSKI",
        "first_name": "ELEN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.025969",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; 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.