NPIMap

Organization Active NPI

Greg Elwell, D.M.D., P.C.

  • General Practice Dentistry
  • Canton, GA
National Provider Identifier
1124105507
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN011688 Issued in GA
Legal business name
GREG ELWELL, D.M.D., P.C.
Practice address
24 Waleska St
Canton, GA 30114-2739
Phone
(770) 479-5569
Fax
(770) 479-3492
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Authorized official

Name
Dr. Greg Elwell, D.M.D.
Title
Owner
Phone
(770) 479-5569

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DN011688 GA Primary

Addresses

Primary practice location

24 Waleska St
Canton, GA 30114-2739

Mailing address

24 Waleska St
Canton, GA 30114-2739
Phone (770) 479-5569

National Provider Directory

National Provider Directory

Locations

24 Waleska St
Canton, GA 30114
Phone (770) 479-5569

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1124105507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 WALESKA ST",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142739",
            "telephone_number": "770-479-5569",
            "fax_number": "770-479-3492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 WALESKA ST",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142739",
            "telephone_number": "770-479-5569",
            "fax_number": "770-479-3492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREG ELWELL, D.M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "ELWELL",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-479-5569",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN011688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.