Individual provider Active NPI

Alvin J Elsik Jr., D.D.S.

  • Public Health Dentistry
  • San Antonio, TX
National Provider Identifier
1124107495
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
10693 Issued in TX
Practice address
210 N Rio Grande
San Antonio, TX 78202-3265
Phone
(210) 924-9035
Fax
(210) 924-6273
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X 10693 TX Primary

Addresses

Primary practice location

210 N Rio Grande
San Antonio, TX 78202-3265

Mailing address

332 W Commerce St
San Antonio, TX 78205-2409
Phone (210) 924-9035

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
10693TXMDPublic Health Dentist

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1124107495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 W COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782052409",
            "telephone_number": "210-924-9035",
            "fax_number": "210-924-6273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N RIO GRANDE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782023265",
            "telephone_number": "210-924-9035",
            "fax_number": "210-924-6273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELSIK",
        "first_name": "ALVIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "TX",
            "license": "10693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.