K George Elassal, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

4541 Issued in OK

Practice address

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

Phone

(405) 692-2722

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

No

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

Opted out of Medicare

Yes, effective Jul 1, 2013 through Jul 1, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• K George Elassal DDS Inc

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Oklahoma City, OK
  • NPI 1881704989
  NPD (past) Authorized official

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891805990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11317 S WESTERN AVENUE",
            "address_2": "SUITE 100A",
            "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 100A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731705849",
            "telephone_number": "405-692-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELASSAL",
        "first_name": "K",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OK",
            "license": "4541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "677423",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jose-Marie Albert El-Amm, MD
• Amer El-Arid, PA-C
• Sarah El-Koubysi
• Elaine Demke LLC
• Donna Oline Elam
• Phillip Elassal, DDS
• Ryan Edward Elassal, PT
• Sivaranjani Elavarasan, DDS
• Amru Omar Elayan, PHARMD
• Lucy A Elbah

• Orthodontics and Dentofacial Orthopedics Dentistry in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.