Active NPI
David F Elliott, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Jackson, NJ
National Provider Identifier
1962653592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 22DIO1652800
- Practice address
- 10 S New Prospect Rd
Suite 23
Jackson, NJ 08527-1645 - Phone
- (732) 364-3322
- Fax
- (732) 364-7922
- NPI assigned
- Oct 1, 2008
- Last updated
- Oct 1, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 22DIO1652800 | NJ | Primary |
Addresses
Primary practice location
10 S New Prospect Rd
Suite 23
Jackson, NJ 08527-1645
Mailing address
10 S New Prospect Rd
Suite 23
Jackson, NJ 08527-1645
Phone (732) 364-3322
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 |
|---|---|---|---|
| 22DIO1652800 | NJ | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222819200000",
"number": "1962653592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 S NEW PROSPECT RD",
"address_2": "SUITE 23",
"city": "JACKSON",
"state": "NJ",
"postal_code": "085271645",
"telephone_number": "732-364-3322",
"fax_number": "732-364-7922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 S NEW PROSPECT RD",
"address_2": "SUITE 23",
"city": "JACKSON",
"state": "NJ",
"postal_code": "085271645",
"telephone_number": "732-364-3322",
"fax_number": "732-364-7922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "DAVID",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-10-01",
"last_updated": "2008-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NJ",
"license": "22DIO1652800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.