Connor George Elmitt, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DDS-09099 Issued in IA

Practice address

5495 NW 100TH St
Johnston, IA 50131-4808

Phone

(515) 331-1600

NPI assigned

Jun 25, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Furrow Family Dentistry, PLC

  • General Practice Dentistry
  • Johnston, IA
  • NPI 1851041917
  NPD (past)

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1942615232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5495 NW 100TH ST",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501314808",
            "telephone_number": "515-331-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5495 NW 100TH ST",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501314808",
            "telephone_number": "515-331-1600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5965 Merle Hay Road",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Johnston",
            "state": "IA",
            "postal_code": "50131",
            "country_code": "US",
            "telephone_number": "515-253-0405",
            "fax_number": "515-276-3229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELMITT",
        "first_name": "CONNOR",
        "middle_name": "GEORGE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-25",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "DDS-09099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Johnston, IA
• Providers in Johnston, IA by specialty
• Dentist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; 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.