Elan Okemos LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ELAN OKEMOS LLC

Practice address

2445 Woodlake Cir
Okemos, MI 48864-5941

Phone

(734) 662-7874

NPI assigned

Jul 19, 2021

Last updated

Jul 19, 2021By 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. Sergio Mauricio Moeller, DDS

Title

Dentist/ Owner

Phone

(734) 276-2541

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sergio Mauricio Moeller Zevallos, DDS, MS

  • Prosthodontics
  • Ann Arbor, MI
  • NPI 1790970663
  NPD

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626652800000",
    "number": "1245803295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481046145",
            "telephone_number": "734-662-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2445 WOODLAKE CIR",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488645941",
            "telephone_number": "734-662-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELAN OKEMOS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-19",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A",
        "authorized_official_last_name": "MOELLER",
        "authorized_official_first_name": "SERGIO",
        "authorized_official_middle_name": "MAURICIO",
        "authorized_official_title_or_position": "DENTIST/ OWNER",
        "authorized_official_telephone_number": "734-276-2541",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward W. Sparrow Hospital Association (Sparrow Walk-In Care Lansing)
• Edward W. Sparrow Hospital Association (Sparrow Medical Group Okemos)
• Halle Egan
• Ariana Eggleston
• Katie El-Behairy
• Isis Elassad
• Cole Eldridge
• Kara Suzanne Eldridge, PT
• Elevate Therapy Services, LLC (AdaPTive Mobility Solutions)
• Elijah Counseling Services LLC

• Dental Clinic/Center in Okemos, MI
• Providers in Okemos, MI by specialty
• Dental Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.