Individual provider Active NPI

Elias Sanie, DDS

  • Dentist
  • Rocky Mount, VA
National Provider Identifier
1013402320
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401416677 Issued in VA
Practice address
740 Old Franklin Tpke
Rocky Mount, VA 24151-5881
Phone
(540) 489-8191
NPI assigned
Jun 28, 2018
Last updated
Oct 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DL13686 MA
Dentist 122300000X DL14124 MA
Dentist 122300000X 0401416677 VA Primary

Addresses

Primary practice location

740 Old Franklin Tpke
Rocky Mount, VA 24151-5881

Mailing address

9708 Five Oaks Rd
Fairfax, VA 22031-1109
Phone (571) 228-2826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191024000965 MA Practitioner - Dentist 7517296551 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DL13686MAMDDentist
DL14124MAMDDentist
0401416677VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Programs, Inc. CurrentSince Aug 1, 2019 Accepting new patients
Community Health Programs, Inc. CurrentSince Aug 1, 2019 Accepting new patients
Berkshire Medical Center Inc. PastSince Sep 1, 2019 Accepting new patients
Community Health Programs PastSince Apr 6, 2023 Accepting new patients

Locations

510 North St
Ste 2
Pittsfield, MA 01201
Phone (413) 447-2781

Networks

  • KY PPO C-SNP

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1013402320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9708 FIVE OAKS RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220311109",
            "telephone_number": "571-228-2826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 OLD FRANKLIN TPKE",
            "city": "ROCKY MOUNT",
            "state": "VA",
            "postal_code": "241515881",
            "telephone_number": "540-489-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANIE",
        "first_name": "ELIAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-28",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DL13686",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DL14124",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401416677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, VA

Sources for this page

Verify at the official NPI Registry.