Individual provider Active NPI

Elaine Ruth Allen, D.M.D.

  • General Practice Dentistry
  • Oakland, MD
National Provider Identifier
1578698015
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14360 Issued in MD
Practice address
15703 Garrett Hwy
Oakland, MD 21550-4030
Phone
(301) 334-2225
NPI assigned
Feb 23, 2007
Last updated
Jan 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 14360 MD
General Practice Dentistry 1223G0001X 035407 PA
General Practice Dentistry 1223G0001X 14360 MD Primary

Addresses

Primary practice location

15703 Garrett Hwy
Oakland, MD 21550-4030

Mailing address

15703 Garrett Hwy
Oakland, MD 21550-4030
Phone (301) 334-2225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141223001287 MD Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2567785520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14360MDMDDentist
035407PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Irwin Family Dental, LLC General Practice Past Accepting new patients
William R. Yant, D.D.S., P.a. General Practice PastSince Jan 21, 2022 Accepting new patients
David Stark, DMD General Practice Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1578698015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15703 GARRETT HWY",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215504030",
            "telephone_number": "301-334-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15703 GARRETT HWY",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215504030",
            "telephone_number": "301-334-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "ELAINE",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2022-01-12",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "14360",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "035407",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "14360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, MD

Sources for this page

Verify at the official NPI Registry.