NPIMap

Organization Active NPI

Elite Denal Care P.C.

  • Dentist
  • Elmhurst, NY
National Provider Identifier
1154463016
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
048412 Issued in NY
Legal business name
ELITE DENAL CARE P.C.
Practice address
9438 59TH Ave
Elmhurst, NY 11373-5151
Phone
(718) 699-1100
Fax
(718) 699-1300
NPI assigned
Feb 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. David Gavlin, DDSNPI 1194825018
Title
Pres
Phone
(718) 699-1100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 048412 NY Primary

Addresses

Primary practice location

9438 59TH Ave
Elmhurst, NY 11373-5151

Mailing address

9438 59TH Ave
Elmhurst, NY 11373-5151
Phone (718) 699-1100

Other identifiers 1

IdentifierTypeStateIssuer
02647501MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154463016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9438 59TH AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735151",
            "telephone_number": "718-699-1100",
            "fax_number": "718-699-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9438 59TH AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735151",
            "telephone_number": "718-699-1100",
            "fax_number": "718-699-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE DENAL CARE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GAVLIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "718-699-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "048412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02647501",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.