Individual provider Active NPI

Maegan Elam, D.D.S.

  • Dentist
  • Bedford, TX
National Provider Identifier
1598020901
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
28141 Issued in TX
Practice address
2221 Harwood Rd
Bedford, TX 76021-3607
Phone
(817) 283-2871
NPI assigned
Jul 11, 2012
Sex
Female
Sole proprietor
Yes

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 28141 TX Primary

Addresses

Primary practice location

2221 Harwood Rd
Bedford, TX 76021-3607

Mailing address

2221 Harwood Rd
Bedford, TX 76021-3607
Phone (817) 241-3535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160111000584 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4981906708

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28141TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Maegan Elam, DDS and Associates, PLLC CurrentSince Dec 5, 2021 Accepting new patients
Associates in General Dentistry of TX Dentist PastSince Mar 28, 2021 Accepting new patients

Locations

2221 Harwood Rd
Bedford, TX 76021
Phone (817) 241-3535

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.

NPI Registry JSON

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1598020901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 HARWOOD RD",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760213607",
            "telephone_number": "817-241-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 HARWOOD RD",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760213607",
            "telephone_number": "817-283-2871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELAM",
        "first_name": "MAEGAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "28141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

Verify at the official NPI Registry.