Individual provider Active NPI

Marinos Vasiliou Lilikas, D.M.D

  • General Practice Dentistry
  • Bayonne, NJ
National Provider Identifier
1801003108
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DIO16087 Issued in NJ
Practice address
588 Broadway
Bayonne, NJ 07002-3826
Phone
(201) 437-1177
Fax
(201) 437-5121
NPI assigned
May 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DIO16087 NJ Primary

Addresses

Primary practice location

588 Broadway
Bayonne, NJ 07002-3826

Mailing address

588 Broadway
Bayonne, NJ 07002-3826
Phone (201) 437-1177

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
DIO16087NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801003108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "588 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023826",
            "telephone_number": "201-437-1177",
            "fax_number": "201-437-5121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "588 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023826",
            "telephone_number": "201-437-1177",
            "fax_number": "201-437-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILIKAS",
        "first_name": "MARINOS",
        "middle_name": "VASILIOU",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DIO16087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.