Dr Afsoon Elmore DDS PLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DN16958 Issued in FL

Legal business name

DR AFSOON ELMORE DDS PLC

Practice address

668 N Orlando Ave
Suite1008
Maitland, FL 32751-4473

Phone

(407) 629-6464

Fax

(407) 629-0031

NPI assigned

Feb 2, 2015

Last updated

Feb 2, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Afsoon Elmore, DDS

Title

Owner

Phone

(407) 629-6464

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1422835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422835200000",
    "number": "1194115956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 N ORLANDO AVE",
            "address_2": "SUITE1008",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514473",
            "telephone_number": "407-629-6464",
            "fax_number": "407-629-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "668 N ORLANDO AVE",
            "address_2": "SUITE1008",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514473",
            "telephone_number": "407-629-6464",
            "fax_number": "407-629-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR AFSOON ELMORE DDS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-02",
        "last_updated": "2015-02-02",
        "status": "A",
        "authorized_official_last_name": "ELMORE",
        "authorized_official_first_name": "AFSOON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-629-6464",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN16958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "075545100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Maitland, FL
• Providers in Maitland, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; 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.