Individual provider Active NPI

Elliot NG, DDS

  • General Practice Dentistry
  • Elmhurst, NY
National Provider Identifier
1104139922
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
051521 Issued in NY
Practice address
8609 Justice Ave
Elmhurst, NY 11373-4555
Phone
(718) 271-0303
NPI assigned
Jul 21, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 051521 NY Primary

Addresses

Primary practice location

8609 Justice Ave
Elmhurst, NY 11373-4555

Mailing address

8609 Justice Ave
Elmhurst, NY 11373-4555
Phone (718) 271-0303

Other names 1

  • None None Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160224000492 NY Order and Referring Only - DentistPractitioner - Dentist 2668777905

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279670400000",
    "number": "1104139922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8609 JUSTICE AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734555",
            "telephone_number": "718-271-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8609 JUSTICE AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734555",
            "telephone_number": "718-271-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NG",
        "first_name": "ELLIOT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-21",
        "last_updated": "2010-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "051521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NONE",
            "last_name": "NONE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.