Elenbaas & Doty, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0293496 Issued in MS

Legal business name

ELENBAAS & DOTY, PLLC

Doing business as

Beach View Dental

Practice address

1924 E Pass Rd
Gulfport, MS 39507-3715

Phone

(228) 896-1840

Fax

(228) 604-4449

NPI assigned

Jun 9, 2009

Last updated

Jun 9, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Andrea Burger Elenbaas, DMD

Title

Owner/Dentist

Phone

(228) 896-1840

Specialties & licenses 1

Addresses

Other names 1

• Beach View Dental Doing business as

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

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244505600000",
    "number": "1053547794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 E PASS RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395073715",
            "telephone_number": "228-896-1840",
            "fax_number": "228-604-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 E PASS RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395073715",
            "telephone_number": "228-896-1840",
            "fax_number": "228-604-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELENBAAS & DOTY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-09",
        "last_updated": "2009-06-09",
        "status": "A",
        "authorized_official_last_name": "ELENBAAS",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "BURGER",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "228-896-1840",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "0293496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beach View Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Andrea Elenbaas, D.M.D.
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• Michelle Marie Eleuterius, LCSW
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• General Practice Dentistry in Gulfport, MS
• Providers in Gulfport, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2009; 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.