Individual provider Active NPI

Mahr F Elder, D.D.S., M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Novato, CA
National Provider Identifier
1841301371
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
46586 Issued in CA
Practice address
1805 Novato Blvd
Suite #1
Novato, CA 94947-2934
Phone
(415) 892-1190
Fax
(415) 892-7355
NPI assigned
Aug 31, 2006
Last updated
Mar 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 46586 CA Primary

Addresses

Primary practice location

1805 Novato Blvd
Suite #1
Novato, CA 94947-2934

Mailing address

140 Admiral Callaghan LN Ste B
Vallejo, CA 94591-4005
Phone (707) 552-5644

Other identifiers 3

IdentifierTypeStateIssuer
G9380301OtherCAMEDI-CAL PROVIDER ID#
523194OtherCAMEDI-CAL ID NUMBER
9179922OtherCACMSP PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150702000586 CA Practitioner - Oral Surgery 3173762465 Reassigns benefits to 1 organization
I20250514000027 TX Practitioner - General Surgery 3173762465 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
46586CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
M Elder D D S a Professional Corporation Oral and Maxillofacial Surgery CurrentSince May 9, 2016 Accepting new patients
Partnership Health Services Inc CurrentSince Sep 10, 2024 Accepting new patients
Partnership Health Services Inc Past Accepting new patients

Locations

1590 Webster St
Ste E
Fairfield, CA 94533
Phone (707) 759-5550

1130 Coffee Rd
Modesto, CA 95355
Phone (209) 846-9393

1805 Novato Blvd
Ste 1
Novato, CA 94947
Phone (415) 892-1190

2150 Appian Way
Ste 201
Pinole, CA 94564
Phone (510) 724-3922

125 N Jackson Ave
Ste 202
San Jose, CA 95116
Phone (408) 259-6774

433 Estudillo Ave
San Leandro, CA 94577
Phone (510) 351-9198

433 Estudillo Ave
Ste 306
San Leandro, CA 94577
Phone (510) 483-1600

6529 Inglewood Ave
Stockton, CA 95207
Phone (209) 473-3788

6529 Inglewood Ave
Ste A1
Stockton, CA 95207
Phone (209) 473-3788

140 Admiral Callaghan Ln
Ste B
Vallejo, CA 94591

150 Admiral Callaghan Ln
Ste A
Vallejo, CA 94591
Phone (415) 892-1190

150 Admiral Callaghan Ln
Ste B
Vallejo, CA 94591

19 Rotary Way
Vallejo, CA 94591
Phone (415) 892-1190

5900 Balcones Dr
Ste 100
Austin, TX 78731

3211 W Grand Pkwy N
Ste 600
Katy, TX 77449
Phone (925) 231-1475

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DGHHDD/Endpoint/DGHHDD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1841301371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 ADMIRAL CALLAGHAN LN STE B",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945914005",
            "telephone_number": "707-552-5644",
            "fax_number": "707-552-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 NOVATO BLVD",
            "address_2": "SUITE #1",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949472934",
            "telephone_number": "415-892-1190",
            "fax_number": "415-892-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDER",
        "first_name": "MAHR",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "46586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PROVIDER ID#",
            "identifier": "G9380301",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL ID NUMBER",
            "identifier": "523194",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMSP PROVIDER NUMBER",
            "identifier": "9179922",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Novato, CA

Sources for this page

Verify at the official NPI Registry.