Active NPI
Michael Robert Eliasz, D.D.S.
- General Practice Dentistry
- Dallas, TX
National Provider Identifier
1902925993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 14394
- Practice address
- 8215 Westchester Dr
Suite 145
Dallas, TX 75225-6103 - Phone
- (214) 363-1603
- Fax
- (214) 363-4295
- NPI assigned
- Mar 29, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 14394 | TX | Primary |
Addresses
Primary practice location
8215 Westchester Dr
Suite 145
Dallas, TX 75225-6103
Mailing address
5200 Keller Springs Rd
#1132
Dallas, TX 75248-2723
Phone (972) 458-9240
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14394 | Other | TX | STATE DENTAL LICENSE NUM. |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14394 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902925993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5200 KELLER SPRINGS RD",
"address_2": "#1132",
"city": "DALLAS",
"state": "TX",
"postal_code": "752482723",
"telephone_number": "972-458-9240",
"fax_number": "214-363-4295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8215 WESTCHESTER DR",
"address_2": "SUITE 145",
"city": "DALLAS",
"state": "TX",
"postal_code": "752256103",
"telephone_number": "214-363-1603",
"fax_number": "214-363-4295"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELIASZ",
"first_name": "MICHAEL",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "14394",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE DENTAL LICENSE NUM.",
"identifier": "14394",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.