NPIMap

Organization Active NPI

K George Elassal DDS Inc

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Oklahoma City, OK
National Provider Identifier
1881704989
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
4541 Issued in OK
Legal business name
K GEORGE ELASSAL DDS INC
Practice address
11317 S Western Avenue
Suite 100 a
Oklahoma City, OK 73170-5849
Phone
(405) 692-2722
NPI assigned
Aug 30, 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. K George Elassal, DDSNPI 1891805990
Title
President
Phone
(405) 692-2722

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 4541 OK Primary

Addresses

Primary practice location

11317 S Western Avenue
Suite 100 a
Oklahoma City, OK 73170-5849

Mailing address

11317 S Western Avenue
Suite 100 a
Oklahoma City, OK 73170-5849
Phone (405) 692-2722

Other identifiers 2

IdentifierTypeStateIssuer
332664771001OtherBCBS
677423OtherUNITED CONCORDIA

National Provider Directory

National Provider Directory

Locations

11317 S Western Ave
Ste 100A
Oklahoma City, OK 73170
Phone (405) 692-2722

Practitioners & affiliated clinicians

Practitioners 1

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": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881704989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11317 S WESTERN AVENUE",
            "address_2": "SUITE 100 A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731705849",
            "telephone_number": "405-692-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11317 S WESTERN AVENUE",
            "address_2": "SUITE 100 A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731705849",
            "telephone_number": "405-692-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K GEORGE ELASSAL DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELASSAL",
        "authorized_official_first_name": "K",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-692-2722",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OK",
            "license": "4541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "332664771001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "677423",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

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.