Stephen Girard Elder, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

2901013050 Issued in MI

Practice address

19959 Van Dyke St
Detroit, MI 48234-3211

Phone

(313) 366-8790

Fax

(313) 366-8786

NPI assigned

Oct 23, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Van Dyke Dental Dr Elder & Associates

  • Dentist
  • Detroit, MI
  • NPI 1578001780
  NPD (past) Authorized official

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427131499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19959 VAN DYKE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482343211",
            "telephone_number": "313-366-8790",
            "fax_number": "313-366-8786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19959 VAN DYKE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482343211",
            "telephone_number": "313-366-8790",
            "fax_number": "313-366-8786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDER",
        "first_name": "STEPHEN",
        "middle_name": "GIRARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901013050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam J. Elder, MD
• Jack S Elder, MD
• Lataren D Elder
• Madina Elder, PHARMD
• Mahir Darrar Elder, MD
• Zachary Elder, MD
• Jessica Elderkin
• Frances Ethel Eldis, PH.D., CCC-A/SLP
• Elizabeth Jane Eldon, MD
• April Michele Eldridge

• Dentist in Detroit, MI
• Providers in Detroit, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.