Provider Demographics
NPI:1023188661
Name:LILL, DANIEL JOEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOEL
Last Name:LILL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2523 GOLDENFIELD LN
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6433
Mailing Address - Country:US
Mailing Address - Phone:540-667-0822
Mailing Address - Fax:
Practice Address - Street 1:1010 AMHERST ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3308
Practice Address - Country:US
Practice Address - Phone:540-667-9662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014105671223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics