Individual provider Active NPI

Michael P Elliott, DMD

  • Dentist
  • Erlanger, KY
National Provider Identifier
1083753313
Registry record updated Feb 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8105 Issued in KY
Practice address
3211 Dixie Hwy
Erlanger, KY 41018-1831
Phone
(859) 331-8898
Fax
(859) 331-9201
NPI assigned
Feb 5, 2007
Last updated
Feb 13, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8105 KY Primary

Addresses

Primary practice location

3211 Dixie Hwy
Erlanger, KY 41018-1831

Mailing address

3211 Dixie Hwy
Erlanger, KY 41018-1831
Phone (859) 331-8898

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
8105KYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360713600000",
    "number": "1083753313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 DIXIE HWY",
            "city": "ERLANGER",
            "state": "KY",
            "postal_code": "410181831",
            "telephone_number": "859-331-8898",
            "fax_number": "859-331-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 DIXIE HWY",
            "city": "ERLANGER",
            "state": "KY",
            "postal_code": "410181831",
            "telephone_number": "859-331-8898",
            "fax_number": "859-331-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2013-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "8105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erlanger, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2013; 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.