Active NPI
Elysa Bailey Demorais, D.D.S.
- Dentist
- Greensboro, NC
National Provider Identifier
1568657492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8492
- Practice address
- 900 Summit Ave
Greensboro, NC 27405-7918 - Phone
- (336) 370-1112
- Fax
- (336) 544-0739
- NPI assigned
- Sep 13, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8492 | NC | Primary |
Addresses
Primary practice location
900 Summit Ave
Greensboro, NC 27405-7918
Mailing address
900 Summit Ave
Greensboro, NC 27405-7918
Phone (336) 370-1112
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 |
|---|---|---|---|
| 8492 | NC | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rafael Rivera, Jr., DDS, PLLC | Dentist | Past | Accepting new patients |
| Ballance & Derose DDS PA | 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
- Greensboro, NC
- NPI 1053344630
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189641600000",
"number": "1568657492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 SUMMIT AVE",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274057918",
"telephone_number": "336-370-1112",
"fax_number": "336-544-0739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 SUMMIT AVE",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274057918",
"telephone_number": "336-370-1112",
"fax_number": "336-544-0739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMORAIS",
"first_name": "ELYSA",
"middle_name": "BAILEY",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-13",
"last_updated": "2007-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NC",
"license": "8492",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.