Michael Dotson Elliott, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2410 Issued in AZ

Practice address

564 W 9TH PL
Suite 1
Mesa, AZ 85201-4069

Phone

(480) 833-8064

Fax

(480) 962-8263

NPI assigned

Dec 30, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296000000000",
    "number": "1760469787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 W 9TH PL",
            "address_2": "SUITE 1",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852014069",
            "telephone_number": "480-833-8064",
            "fax_number": "480-962-8263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 W 9TH PL",
            "address_2": "SUITE 1",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852014069",
            "telephone_number": "480-833-8064",
            "fax_number": "480-962-8263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "MICHAEL",
        "middle_name": "DOTSON",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2011-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "2410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "083353",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elliot Smiles Dentistry, LLP
• Demetrius Elliott
• Jeffrey Bryan Elliott, M.C.
• Job Elliott, L.P.C ;L.I.A.C
• John Palmer Elliott, M.D.
• Sandra Marie Elliott, PT, MPT
• Anna Ellis, MA, CCC-A
• Devin Alexander Ellis, LPC
• Ellsworth Foot and Ankle PLLC
• Ellsworth Physician Services

• Oral and Maxillofacial Surgery (Dentist) in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Oral and Maxillofacial Surgery (Dentist) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2011; 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.