Active NPI
Dean Elattrache, DMD MS
- Endodontics
- Virginia Beach, VA
National Provider Identifier
1043463169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 0401410744
- Practice address
- 2020 General Booth Blvd Ste 100
Virginia Beach, VA 23454-5875 - Phone
- (757) 427-0144
- Fax
- (757) 427-0145
- NPI assigned
- Nov 3, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 0401410744 | VA | Primary |
Addresses
Primary practice location
2020 General Booth Blvd Ste 100
Virginia Beach, VA 23454-5875
Mailing address
2020 General Booth Blvd
Suite 100
Virginia Beach, VA 23454
Phone (757) 427-0144
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401410744 | VA | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225670400000",
"number": "1043463169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2020 GENERAL BOOTH BLVD",
"address_2": "SUITE 100",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "23454",
"telephone_number": "757-427-0144",
"fax_number": "757-427-0145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 GENERAL BOOTH BLVD STE 100",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234545875",
"telephone_number": "757-427-0144",
"fax_number": "757-427-0145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELATTRACHE",
"first_name": "DEAN",
"credential": "DMD MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-11-03",
"last_updated": "2008-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "VA",
"license": "0401410744",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.