MEDICARE: MONDIRA LILIAN GOMES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN10001388	MA

General Provider Information

NPI Number	:	1841133105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONDIRA LILIAN GOMES

Provider Business Mailing Address
First Line	:	1200 BULL SHOALS LN
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27513-5808
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 BULL SHOALS LN
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27513-5808
Country	:	US
Telephone Number	:	984-292-8866
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	06/02/2026

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Directions to “ MONDIRA LILIAN GOMES ” Practice Location

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