Active NPI
Lisa Elias, DDS, MSD
- Endodontics
- Council Bluffs, IA
National Provider Identifier
1942542998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 09979
- Practice address
- 320 McKenzie Ave Ste 207
Council Bluffs, IA 51503-1002 - Phone
- (712) 256-9943
- NPI assigned
- Mar 17, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 60846271 | WA | |
| Endodontics | 1223E0200X | 09979 | IA | Primary |
Addresses
Primary practice location
320 McKenzie Ave Ste 207
Council Bluffs, IA 51503-1002
Mailing address
4217 Sunset Dr W
University Place, WA 98466-2408
Phone (989) 928-7473
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 |
|---|---|---|---|
| 09979 | IA | MD | Endodontist |
| 60846271 | WA | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699228800000",
"number": "1942542998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4217 SUNSET DR W",
"city": "UNIVERSITY PLACE",
"state": "WA",
"postal_code": "984662408",
"telephone_number": "989-928-7473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 MCKENZIE AVE STE 207",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515031002",
"telephone_number": "712-256-9943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELIAS",
"first_name": "LISA",
"credential": "DDS, MSD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-17",
"last_updated": "2023-11-06",
"certification_date": "2023-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "WA",
"license": "60846271",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "IA",
"license": "09979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Council Bluffs, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.