Active NPI
Elisheva Niedelman, D.M.D
- General Practice Dentistry
- Garland, TX
National Provider Identifier
1356775761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 33555
- Practice address
- 1215 Thomasville
Garland, TX 75044-3478 - Phone
- (972) 494-0004
- NPI assigned
- Aug 21, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS139515 | PA | |
| General Practice Dentistry | 1223G0001X | 33555 | TX | Primary |
Addresses
Primary practice location
1215 Thomasville
Garland, TX 75044-3478
Mailing address
2200 Benjamin Franklin Pkwy
Apt E1505
Philadelphia, PA 19130-3601
Phone (267) 226-1358
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS139515 | PA | MD | Dentist |
| 33555 | TX | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Philadelphia Dental | General Practice | Past | Accepting new patients |
| Dentex Dental Group | General Practice | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Philadelphia, PA
- NPI 1770861130
-
- General Practice Dentistry
- Philadelphia, PA
- NPI 1306734447
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666569600000",
"number": "1356775761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 BENJAMIN FRANKLIN PKWY",
"address_2": "APT E1505",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191303601",
"telephone_number": "267-226-1358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1215 THOMASVILLE",
"city": "GARLAND",
"state": "TX",
"postal_code": "750443478",
"telephone_number": "972-494-0004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIEDELMAN",
"first_name": "ELISHEVA",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-21",
"last_updated": "2022-10-24",
"certification_date": "2022-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS139515",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "33555",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.