Organization Active NPI

Elizabethtown Dental Associates

  • General Practice Dentistry
  • Elizabethtown, PA
National Provider Identifier
1043378755
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ELIZABETHTOWN DENTAL ASSOCIATES
Practice address
100 Continential Drive
Elizabethtown, PA 17022
Phone
(717) 367-1336
Fax
(717) 367-7904
NPI assigned
Dec 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Edward E White Jr., DDS
Title
Dentist Ceo
Phone
(717) 367-1336

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

100 Continential Drive
Elizabethtown, PA 17022

Mailing address

100 Continential Drive
Elizabethtown, PA 17022
Phone (717) 367-1336

Other identifiers 1

IdentifierTypeStateIssuer
196127OtherPABS

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043378755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CONTINENTIAL DRIVE",
            "city": "ELIZABETHTOWN",
            "state": "PA",
            "postal_code": "17022",
            "telephone_number": "717-367-1336",
            "fax_number": "717-367-7904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CONTINENTIAL DRIVE",
            "city": "ELIZABETHTOWN",
            "state": "PA",
            "postal_code": "17022",
            "telephone_number": "717-367-1336",
            "fax_number": "717-367-7904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETHTOWN DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DENTIST CEO",
        "authorized_official_telephone_number": "717-367-1336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "196127",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.