Iana Elledge, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

35430 Issued in TX

Practice address

4801 Amarra Dr
Austin, TX 78735-1845

Phone

(408) 221-9128

NPI assigned

Jul 24, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Smile Salon, PLLC

  dba Glint Dental

  • Dental Clinic/Center
  • Austin, TX
  • NPI 1033814710
  NPD Authorized official

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1619520087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S 1ST ST STE 160",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787043048",
            "telephone_number": "512-653-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 AMARRA DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787351845",
            "telephone_number": "408-221-9128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLEDGE",
        "first_name": "IANA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "35430",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "35430",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elise Elkins
• Katherine N Elkins, OD
• Michael Elkins, PA-C
• Savannah Denise Baker Elkins, PA-C
• Dianne Elizabeth Elledge, D.O.
• Ellen Johnson Counseling, PLLC (Decades Counseling)
• Morgan Eller
• Donald C Ellerbe, LCDC
• Cory R Ellerbroek, D.C.
• Ellie Rogers Counseling PLLC

• General Practice Dentistry in Austin, TX
• Providers in Austin, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; 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.