Dijana Elmejdoubi, DDS, MS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DEN.00205511 Issued in CO

Practice address

Fountain Modern Dentistry and Orthodontics
6940 Mesa Ridge Parkway
Fountain, CO 80817-1533

Phone

(719) 229-4076

NPI assigned

Jul 14, 2022

Last updated

Aug 27, 2024By the provider in NPPES

Sex

Female

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1942934914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FOUNTAIN MODERN DENTISTRY AND ORTHODONTICS",
            "address_2": "6940 MESA RIDGE PARKWAY",
            "city": "FOUNTAIN",
            "state": "CO",
            "postal_code": "808171533",
            "telephone_number": "719-229-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FOUNTAIN MODERN DENTISTRY AND ORTHODONTICS",
            "address_2": "6940 MESA RIDGE PARKWAY",
            "city": "FOUNTAIN",
            "state": "CO",
            "postal_code": "808171533",
            "telephone_number": "719-229-4076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Florida Ave",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701192715",
            "country_code": "US",
            "telephone_number": "719-229-4076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELMEJDOUBI",
        "first_name": "DIJANA",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-14",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CO",
            "license": "DEN.00205511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Mae Eby, DPT
• Lisa Edwards
• Cynthia Louise Eiferd, CNA
• Elite Dental Group Fountain Inc (Johnson And Associates)
• Julian Resto Elizondo
• Emergency Medical Specialists, PC
• Emergency Medical Specialists, PC
• Enduring Hope LLC
• Engels Therapeutic Consulting PLLC
• Ebony Lecole Ephriam

• Endodontics in Fountain, CO
• Providers in Fountain, CO by specialty
• Endodontics in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.