NPIMap

Organization Active NPI

Elkdental LLC

  • Dentist
  • Decatur, GA
National Provider Identifier
1346694866
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
ELKDENTAL LLC
Practice address
1423 Church St
Decatur, GA 30030-1527
Phone
(706) 832-5541
Fax
(706) 832-5541
NPI assigned
Apr 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Authorized official

Name
Moataz ElkasrawyNPI 1588906572
Title
Owner
Phone
(706) 832-5541

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1423 Church St
Decatur, GA 30030-1527

Mailing address

1423 Church St
Decatur, GA 30030-1527
Phone (404) 902-7292

Other names 2

  • Aspen Dental Doing business as
  • Elkdental Doing business as

National Provider Directory

National Provider Directory

Locations

1423 Church St
Decatur, GA 30030
Phone (404) 377-0011

201 Newnan Crossing Byp
Newnan, GA 30265
Phone (678) 621-6410

Practitioners & affiliated clinicians

Practitioners 9

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": "1461196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762819200000",
    "number": "1346694866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 CHURCH ST",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301527",
            "telephone_number": "404-902-7292",
            "fax_number": "404-902-7291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 CHURCH ST",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301527",
            "telephone_number": "706-832-5541",
            "fax_number": "706-832-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELKDENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-21",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A",
        "authorized_official_last_name": "ELKASRAWY",
        "authorized_official_first_name": "MOATAZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-832-5541"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspen Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Elkdental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2025; 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.