Laura David Ellefson, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

100710 Issued in CA

Practice address

1100 Sonoma Ave Ste a
Santa Rosa, CA 95405-8901

Phone

(707) 527-0363

NPI assigned

Feb 22, 2013

Last updated

Mar 9, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Ellefson & Marelich Dental Corporation

  • Dentist
  • Santa Rosa, CA
  • NPI 1942728241
  NPD Authorized official

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

{
    "created_epoch": "1361491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520553600000",
    "number": "1427398882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 SONOMA AVE STE A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954058901",
            "telephone_number": "707-527-0363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 SONOMA AVE STE A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954058901",
            "telephone_number": "707-527-0363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLEFSON",
        "first_name": "LAURA",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-22",
        "last_updated": "2018-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "100710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70339520",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Elias, M.D.
• Stefany Elias
• Joseph Eliason, DDS, MSD
• Anita Marie Eliot, MA LMFT
• Ellefson & Marelich Dental Corporation
• Mary Ileen Elliff, CRNFA
• Monique Ellington
• Eric Elliott
• Jeffrey Craig Elliott, D.D.S.
• Liam Kenneth Elliott, FNP

• Dentist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2018; 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.