Elaine Grace G Ellorin DMD Inc

Primary specialty

DentistTaxonomy code 122300000X

License

46788 Issued in CA

Legal business name

ELAINE GRACE G ELLORIN DMD INC

Practice address

911B East Duane Ave
Sunnyvale, CA 94085-3438

Phone

(408) 736-7299

Fax

(408) 736-7298

NPI assigned

Jan 30, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Elaine Grace Gacusan Ellorin, DMD

Title

Chief Executive Officer Dentist

Phone

(408) 736-7299

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332201600000",
    "number": "1114063674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911B E DUANE AVE",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940853438",
            "telephone_number": "408-736-7299",
            "fax_number": "408-736-7298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911B EAST DUANE AVE",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940853438",
            "telephone_number": "408-736-7299",
            "fax_number": "408-736-7298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELAINE GRACE G ELLORIN DMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2012-03-20",
        "status": "A",
        "authorized_official_last_name": "ELLORIN",
        "authorized_official_first_name": "ELAINE GRACE",
        "authorized_official_middle_name": "GACUSAN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER DENTIST",
        "authorized_official_telephone_number": "408-736-7299",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "46788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; 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.