Norman Ivan Elloway, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D21984 Issued in CA

Practice address

1316 Grant Ave
Novato, CA 94945-3100

Phone

(415) 897-8338

Fax

(415) 897-4729

NPI assigned

Mar 21, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Norman I. Elloway D.D.S

  • Preferred Provider Organization
  • Novato, CA
  • NPI 1306013495
  NPD (past) Authorized official

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1265558332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 GRANT AVE",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949453100",
            "telephone_number": "415-897-8338",
            "fax_number": "415-897-4729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 GRANT AVE",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949453100",
            "telephone_number": "415-897-8338",
            "fax_number": "415-897-4729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLOWAY",
        "first_name": "NORMAN",
        "middle_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "D21984",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph I Eddings
• Brad J Eigen, BSN, MSN FNP
• Mahr F Elder, D.D.S., M.D.
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• Matthew Engel, LCSW, CHT
• Rodney Lee English
• David William Epstein, DDS
• Shaina Brody Epstein

• General Practice Dentistry in Novato, CA
• Providers in Novato, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.