Active NPI
Elaine Carmella Mamola, RDH
- Dental Hygienist
- Surprise, AZ
National Provider Identifier
1033467113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- H04804
- Practice address
- 15508 W Bell Rd
101-525
Surprise, AZ 85374-2432 - Phone
- (623) 584-4746
- Fax
- (623) 584-4750
- NPI assigned
- Aug 21, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | H04804 | AZ | Primary |
| Dental Hygienist | 124Q00000X | H05302 | AZ |
Addresses
Primary practice location
15508 W Bell Rd
101-525
Surprise, AZ 85374-2432
Mailing address
15508 W Bell Rd
101-525
Surprise, AZ 85374-2432
Phone (623) 584-4746
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
| License | State | Type | Specialty |
|---|---|---|---|
| H04804 | AZ | MD | Dental Hygienist |
| H05302 | AZ | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smiles by Delivery, PLLC | Dental Hygienist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345507200000",
"number": "1033467113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15508 W BELL RD",
"address_2": "101-525",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853742432",
"telephone_number": "623-584-4746",
"fax_number": "623-584-4750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15508 W BELL RD",
"address_2": "101-525",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853742432",
"telephone_number": "623-584-4746",
"fax_number": "623-584-4750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAMOLA",
"first_name": "ELAINE",
"middle_name": "CARMELLA",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-21",
"last_updated": "2012-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "AZ",
"license": "H04804",
"primary": true
},
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "AZ",
"license": "H05302",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.