Elder Dental Group, P.C.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DN00795 Issued in GA

Legal business name

ELDER DENTAL GROUP, P.C.

Practice address

2300 Prince Ave
Athens, GA 30606-6004

Phone

(706) 543-4717

Fax

(706) 543-5091

NPI assigned

Jan 18, 2007

Last updated

Mar 11, 2009By 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

Mrs. Nancy H. Elder

Title

Sec/Tres

Phone

(706) 543-4717

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Herman Anthony Elder, D.M.D.

  • General Practice Dentistry
  • Athens, GA
  • NPI 1407909138
  NPD (past)
• Matthew C. Elder, D.M.D.

  • Dentist
  • Athens, GA
  • NPI 1669491007
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236729600000",
    "number": "1295888956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 PRINCE AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306066004",
            "telephone_number": "706-543-4717",
            "fax_number": "706-543-5091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 PRINCE AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306066004",
            "telephone_number": "706-543-4717",
            "fax_number": "706-543-5091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDER DENTAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2009-03-11",
        "status": "A",
        "authorized_official_last_name": "ELDER",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "SEC/TRES",
        "authorized_official_telephone_number": "706-543-4717",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "GA",
            "license": "DN00795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Komal Ejaz, M.D.
• Stephen Douglas Ekard, MHP
• Nader A El-Kareh
• Jafer Malik Jafer Elabeid, MD
• Elbert County Internal Medicine, L.L.C. (Elbert County Internal Meidicine LLC)
• Cheryl Elder
• Herman Anthony Elder, D.M.D.
• John Frederick Elder, M.D.
• Lindsey Michele Elder
• Matthew C. Elder, D.M.D.

• Dental Clinic/Center in Athens, GA
• Providers in Athens, GA by specialty
• Dental Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2009; 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.