Active NPI
Elite Endodontics
- Endodontics
- Lake Orion, MI
National Provider Identifier
1336654102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 2901020373
- Legal business name
- ELITE ENDODONTICS
- Practice address
- 1135 S Lapeer Rd Ste a
Lake Orion, MI 48360-1432 - Phone
- (616) 502-2846
- NPI assigned
- Dec 2, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Drew Wayne Moeller, DDS, MS
- Title
- Endodontist
- Phone
- (616) 502-2846
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 2901020373 | MI | Primary |
Addresses
Primary practice location
1135 S Lapeer Rd Ste a
Lake Orion, MI 48360-1432
Mailing address
6965 Oakhurst Ridge Rd
Clarkston, MI 48348-5053
National Provider Directory
National Provider DirectoryLocations
1135 S Lapeer Rd
#A
Lake Orion, MI 48360
Phone (616) 502-2846
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512172800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1512172800000",
"number": "1336654102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6965 OAKHURST RIDGE RD",
"city": "CLARKSTON",
"state": "MI",
"postal_code": "483485053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1135 S LAPEER RD STE A",
"city": "LAKE ORION",
"state": "MI",
"postal_code": "483601432",
"telephone_number": "616-502-2846"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ELITE ENDODONTICS",
"organizational_subpart": "NO",
"enumeration_date": "2017-12-02",
"last_updated": "2017-12-02",
"status": "A",
"authorized_official_last_name": "MOELLER",
"authorized_official_first_name": "DREW",
"authorized_official_middle_name": "WAYNE",
"authorized_official_title_or_position": "ENDODONTIST",
"authorized_official_telephone_number": "616-502-2846",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS, MS"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Endodontics",
"state": "MI",
"license": "2901020373",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Orion, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.