Individual provider Active NPI

Michaela Elias

  • Dentist
  • Forest Hills, NY
National Provider Identifier
1083460323
Registry record updated May 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
064892 Issued in NY
Practice address
111-01 Queens Blvd
Forest Hills, NY 11375
Phone
(718) 275-0101
NPI assigned
Apr 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 064892 NY Primary

Addresses

Primary practice location

111-01 Queens Blvd
Forest Hills, NY 11375

Mailing address

11101 Queens Blvd
Forest Hills, NY 11375-5553
Phone (718) 275-0101

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

LicenseStateTypeSpecialty
064892NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1714089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780185600000",
    "number": "1083460323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11101 QUEENS BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755553",
            "telephone_number": "718-275-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111-01 QUEENS BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-275-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIAS",
        "first_name": "MICHAELA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-26",
        "last_updated": "2026-05-31",
        "certification_date": "2026-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "064892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2026; 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.