Individual provider Active NPI

Elizabeth Ann Alcorn, D.D.S.

  • General Practice Dentistry
  • Earlysville, VA
National Provider Identifier
1770690950
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7259 Issued in VA
Practice address
1358 Allen Farm LN
Earlysville, VA 22936-1853
Phone
(434) 690-6990
Fax
(434) 974-1760
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7259 VA Primary

Addresses

Primary practice location

1358 Allen Farm LN
Earlysville, VA 22936-1853

Mailing address

1358 Allen Farm LN
Earlysville, VA 22936-1853
Phone (434) 690-6990

Other names 1

  • Dr. Elizabeth Ann Doerwaldt Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Mar 31, 2016 through Mar 31, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7259VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770690950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1358 ALLEN FARM LN",
            "city": "EARLYSVILLE",
            "state": "VA",
            "postal_code": "229361853",
            "telephone_number": "434-690-6990",
            "fax_number": "434-974-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1358 ALLEN FARM LN",
            "city": "EARLYSVILLE",
            "state": "VA",
            "postal_code": "229361853",
            "telephone_number": "434-690-6990",
            "fax_number": "434-974-1760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALCORN",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "7259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "DOERWALDT",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Earlysville, VA

Sources for this page

Verify at the official NPI Registry.