NPIMap

Organization Active NPI

Elison Orthodontics PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Idaho Falls, ID
National Provider Identifier
1740215870
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
D1702 OR Issued in ID
Legal business name
ELISON ORTHODONTICS PLLC
Doing business as
Joseph H. Elison and/or Joseph Matthew Elison
Practice address
3357 Merlin Dr
Idaho Falls, ID 83404-7405
Phone
(208) 522-9600
Fax
(208) 522-9799
NPI assigned
Jul 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Joseph H. Elison, D.D.S.,M.S.NPI 1710188081
Title
Orthodontist
Phone
(208) 522-9600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X D1702 OR ID Primary

Addresses

Primary practice location

3357 Merlin Dr
Idaho Falls, ID 83404-7405

Mailing address

3357 Merlin Dr
Idaho Falls, ID 83404-7405
Phone (208) 522-9600

Other identifiers 2

IdentifierTypeStateIssuer
000010012467OtherIDBLUE SHIELD OF IDAHO
1634056OtherIDUNITED CONCORDIA

Other names 1

  • Joseph H. Elison and/or Joseph Matthew Elison Doing business as

National Provider Directory

National Provider Directory

Locations

3357 Merlin Dr
Idaho Falls, ID 83404
Phone (208) 522-9600

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740215870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3357 MERLIN DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047405",
            "telephone_number": "208-522-9600",
            "fax_number": "208-522-9799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3357 MERLIN DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047405",
            "telephone_number": "208-522-9600",
            "fax_number": "208-522-9799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELISON ORTHODONTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELISON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "208-522-9600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S.,M.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "ID",
            "license": "D1702 OR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF IDAHO",
            "identifier": "000010012467",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1634056",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Joseph H. Elison and/or Joseph Matthew Elison",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.