Active NPI
Elizabeth L. Forkkio, DMD
- Dentist
- Gaithersburg, MD
National Provider Identifier
1952464182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 13928
- Practice address
- 839-A Quince Orchard Blvd
Gaithersburg, MD 20878 - Phone
- (917) 561-4858
- NPI assigned
- Dec 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 13928 | MD | Primary |
| Public Health Dentistry | 1223D0001X | DEN10000423 | DC |
Addresses
Primary practice location
839-A Quince Orchard Blvd
Gaithersburg, MD 20878
Mailing address
10408 Capehart Court
Gaithersburg, MD 20886
Phone (917) 561-4858
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150701000234 | DC | Order and Referring Only - Dentist | 3678697182 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN10000423 | DC | MD | Public Health Dentist |
Interoperability endpoints
- elizabeth.forkkio.p1@direct.mcg-hhs.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314662400000",
"number": "1952464182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10408 CAPEHART COURT",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "20886",
"telephone_number": "917-561-4858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "839-A QUINCE ORCHARD BLVD",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "20878",
"telephone_number": "917-561-4858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORKKIO",
"first_name": "ELIZABETH",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-19",
"last_updated": "2011-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "13928",
"primary": true
},
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "DC",
"license": "DEN10000423",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.