Sergio Augusto Elias, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14997 Issued in MN

Practice address

8951 Goodrich Rd Apt 111
Bloomington, MN 55437-1634

Phone

(305) 342-3382

NPI assigned

Sep 16, 2021

Sex

Male

Sole proprietor

No

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

Interoperability endpoints

• Direct secure messaging: selias733044@direct.ochin.org

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.

• Leung Dental Care, Inc.

  • General Practice Dentistry
  • North Miami Beach, FL
  • NPI 1154607505
  NPD (past)

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1295405777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8951 GOODRICH RD APT 111",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554371634",
            "telephone_number": "305-342-3382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8951 GOODRICH RD APT 111",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554371634",
            "telephone_number": "305-342-3382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIAS",
        "first_name": "SERGIO",
        "middle_name": "AUGUSTO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-16",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN26235",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kylie Dyann Eitzmann
• Jeffrey N Elder, MD
• Brent A. Elert, MD
• Elevate Mental Health LLC
• Elevated Care Service
• Brian S Elijah, D.C.
• Elisa Sarmento
• William Charles Elkington, D.C.
• Angela JF Ellingson, MS, OTR/L
• James Ellis

• General Practice Dentistry in Bloomington, MN
• Providers in Bloomington, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; 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.