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LILLIA BOLBOLI
NPI 1114601432
Dentist in Davenport, IA

Active since June 15, 2023PECOS Enrolled
1751 E 54TH ST, DAVENPORT, IA 52807(563) 355-6626 Get Directions Write a Review

NPPES record last updated: June 15, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Lillia Bolboli NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LILLIA BOLBOLI (NPI 1114601432) is an individual dentist in Davenport, Iowa, licensed in Iowa (DDS-10114) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Davenport, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1114601432
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameLILLIA BOLBOLI
Location Address1751 E 54TH STDavenport, IA 52807-2769
Mailing Address706 Arch Rock RdIowa City, IA 52245-2700
Phone(563) 355-6626
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateJune 15, 2023
NPPES CertifiedJune 15, 2023
✔ NPI 1114601432 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in IA · DDS-10114
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
1751 E 54TH ST, Davenport, IA 52807
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Secondary Practice Location 1

Location 13475 Jersey Ridge Rd Ste 1Davenport, IA 52807-2293 · Phone (563) 554-2573

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lillia Bolboli is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4688146327
PECOS Enrollment IDI20260615000849
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Lillia Bolboli reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Community Health Centers Of Southeastern Iowa Inc
48 mi
Federally Qualified Health Center (FQHC)
2409 SPRING ST
Columbus City, IA 52737
  • Reassigned Medicare billing, Iowa enrollment
  • 43 clinicians in this Medicare group
NPI 1265618805 (319) 728-7400

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 52807 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.84 typical visit price
range $52.96 – $161.40
Typical copayment $20.46 (range $13.24 – $40.35)
Most-billed visit code 99203
Established Patient
$66.36 typical visit price
range $16.91 – $131.98
Typical copayment $16.59 (range $4.22 – $32.99)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHRYN A. KELL DDS PC
Clinic/Center (Dental)
1751 E 54TH ST
DAVENPORT, IA 52807
Scott County (563) 355-6626
DR. RACHAEL ELIZABETH MARTIN D.D.S.
Dentist (General Practice)
1751 E 54TH ST
DAVENPORT, IA 52807
Scott County (563) 271-8643

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lillia Bolboli's NPI number?

The NPI number for Lillia Bolboli is 1114601432. It was assigned to this individual provider in the NPPES registry on June 15, 2023.

Where is Lillia Bolboli located?

Lillia Bolboli practices at 1751 E 54th St, Davenport, IA 52807. The listed phone number is (563) 355-6626.

What is Lillia Bolboli's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Lillia Bolboli enrolled in Medicare?

Yes. Lillia Bolboli is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Lillia Bolboli's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lillia Bolboli reassigns Medicare benefits to Community Health Centers Of Southeastern Iowa Inc (Columbus City, IA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lillia Bolboli's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lillia Bolboli accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and Blue Cross and Blue Shield of Montana and 6 other insurers list Lillia Bolboli as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lillia Bolboli was last updated on June 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.