Elmore Jr DDS PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

ELMORE JR DDS PLLC

Doing business as

About Face Collaborative

Practice address

4414 Lake Boone TRL Ste 111
Raleigh, NC 27607-7514

Phone

(804) 387-7002

NPI assigned

Jun 23, 2020

Last updated

May 9, 2023By 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. Jasmine R Elmore, DDS, CSOMNPI 1932546157

Title

President/Ceo

Phone

(252) 916-5875

Specialties & licenses 2

Addresses

Other names 1

• About Face Collaborative Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jasmine Renee Elmore, D.D.S.

  • Pediatric Dentistry
  • Wilson, NC
  • NPI 1932546157
  NPD Authorized official

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683590400000",
    "number": "1093331209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4049 LANDOVER PEAK PL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276169796",
            "telephone_number": "252-916-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRL STE 111",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077514",
            "telephone_number": "804-387-7002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 NW Maynard Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275138709",
            "country_code": "US",
            "telephone_number": "804-387-7002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELMORE JR DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-23",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A",
        "authorized_official_last_name": "ELMORE",
        "authorized_official_first_name": "JASMINE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "252-916-5875",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, CSOM"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "About Face Collaborative",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "About Face Collaborative",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maxlyn Lavie Ellison, MD
• Lawrence A. Ellsworth, MSSW, LCSW
• Patricia Ellsworth
• Wagdy Abdelmonem Elmahdy, M.D.
• Andrew Elman Elman, M.A.
• Catherine Elmore
• Jennifer Marie Elmore, LPC
• Rebecca Elmore, BCBA
• Julie Cooper Elms, CRNA
• Anna Ntube Elonge, LCSWA

• Pediatric Dentistry in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Pediatric Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.