Dr. Eldib, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21060 Issued in MI

Legal business name

DR. ELDIB, PLLC

Practice address

1515 E US Highway 223 Ste G
Adrian, MI 49221-4456

Phone

(517) 264-2700

Fax

(517) 264-2744

NPI assigned

Jan 28, 2015

Last updated

Jan 28, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jason Bertollini

Title

PRM

Phone

(866) 273-8204

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ahmed Eldib, B.D.S, DDS

  • Dentist
  • Portage, MI
  • NPI 1699117762
  Medicare reassignment NPD
• Rami Elrefai, DDS

  • Dentist
  • Southfield, MI
  • NPI 1497097448

  Single Specialty

  NPD
• Omar Almadani, DMD

  • Dentist
  • Ann Arbor, MI
  • NPI 1013833755
  NPD (past)
• Asil Ellauzi, BDS. MS

  • Dentist
  • Adrian, MI
  • NPI 1437828399
  NPD (past)
• Joanne Ly, DDS

  • Dentist
  • Adrian, MI
  • NPI 1720757024

  General Practice

  NPD (past)

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

{
    "created_epoch": "1422403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422403200000",
    "number": "1437549425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189",
            "telephone_number": "866-273-8204",
            "fax_number": "866-803-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 E US HIGHWAY 223 STE G",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492214456",
            "telephone_number": "517-264-2700",
            "fax_number": "517-264-2744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. ELDIB, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-28",
        "last_updated": "2015-01-28",
        "status": "A",
        "authorized_official_last_name": "BERTOLLINI",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PRM",
        "authorized_official_telephone_number": "866-273-8204"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "21060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dowling Chiropractic, PC (Maple City Chiropractic)
• Ann Marie Dowling, D.C.
• Jeremy Eric Dowling, D.C.
• Dr Martins Foot and Ankle Clinic
• Dr Martins Foot and Ankle Clinic
• Ciarra Rayne Dubois, B.A
• Amanda Joy Dufty
• Patricia Ann Dulka, LMSW ACSW
• Earth Angel Massage and Aromatherapy LLC
• Mary Joan Ebbitt, LMSW

• General Practice Dentistry in Adrian, MI
• Providers in Adrian, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.