NPIMap

Organization Active NPI

Elvebak Orthodontics, PA

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Plano, TX
National Provider Identifier
1265439699
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
20522 Issued in TX
Legal business name
ELVEBAK ORTHODONTICS, PA
Practice address
6225 Chapel Hill Blvd
Plano, TX 75093-6392
Phone
(972) 931-2700
Fax
(972) 931-2703
NPI assigned
Jun 30, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Dr. Bryan S Elvebak, DDS, MSNPI 1033351408
Title
President
Phone
(972) 931-2700

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
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 20522 TX Primary

Addresses

Primary practice location

6225 Chapel Hill Blvd
Plano, TX 75093-6392

Mailing address

6225 Chapel Hill Blvd
Plano, TX 75093-6392
Phone (972) 931-2700

Other practice location 1

17300 Preston Rd.
Suite 150
Dallas, TX 75252
Phone (972) 931-2700

National Provider Directory

National Provider Directory

Locations

17300 Preston Rd
Ste 150
Dallas, TX 75252
Phone (972) 931-2700

Practitioners & affiliated clinicians

Practitioners 2

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": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1265439699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6225 CHAPEL HILL BLVD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750936392",
            "telephone_number": "972-931-2700",
            "fax_number": "972-931-2703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6225 CHAPEL HILL BLVD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750936392",
            "telephone_number": "972-931-2700",
            "fax_number": "972-931-2703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17300 Preston Rd.",
            "address_2": "Suite 150",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "75252",
            "country_code": "US",
            "telephone_number": "972-931-2700",
            "fax_number": "972-931-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELVEBAK ORTHODONTICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "ELVEBAK",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-931-2700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "20522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.