Individual provider Active NPI

Mona Elzarka, DMD

  • General Practice Dentistry
  • Canaan, NH
National Provider Identifier
1144454760
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
04635 Issued in NH
Practice address
18 Roberts Rd
Canaan, NH 03741-7644
Phone
(603) 523-4343
NPI assigned
May 11, 2009
Last updated
Nov 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 010533 CT
General Practice Dentistry 1223G0001X 04635 NH Primary

Addresses

Primary practice location

18 Roberts Rd
Canaan, NH 03741-7644

Mailing address

18 Roberts Rd
Canaan, NH 03741-7644
Phone (603) 523-4343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20240722003746 NH Practitioner - Dentist 0941746374 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010533CTMDGeneral Practice Dentistry
04635NHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mascoma Community Healthcare Inc CurrentSince Apr 19, 2024 Accepting new patients
Jedidiah L Janisse DMD and Associates, LTD PastSince Mar 1, 2021 Accepting new patients

Locations

18 Roberts Rd
Canaan, NH 03741
Phone (603) 523-4343

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1144454760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 ROBERTS RD",
            "city": "CANAAN",
            "state": "NH",
            "postal_code": "037417644",
            "telephone_number": "603-523-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 ROBERTS RD",
            "city": "CANAAN",
            "state": "NH",
            "postal_code": "037417644",
            "telephone_number": "603-523-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELZARKA",
        "first_name": "MONA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-11",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "010533",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NH",
            "license": "04635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canaan, NH

Sources for this page

Verify at the official NPI Registry.