Individual provider Active NPI

Eleftheria Iris Michelaki, DDS, MSD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Newport News, VA
National Provider Identifier
1982430625
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
0401419040 Issued in VA
Practice address
220 Nat Turner Blvd S
Newport News, VA 23606-2998
Phone
(757) 240-5711
NPI assigned
Sep 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 0401419040 VA Primary

Addresses

Primary practice location

220 Nat Turner Blvd S
Newport News, VA 23606-2998

Mailing address

3 Finikos Street
Athens, GREECE 14564
GR

Other practice location 1

5750 Main St Ste 100a
Gloucester, VA 23061
Phone (804) 695-2575

Other practice location 2

5000 Foundation St
Williamsburg, VA 23188-2872
Phone (757) 259-9703

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

LicenseStateTypeSpecialty
0401419040VAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Orthodontics PLLC Orthodontics and Dentofacial Orthopedics Past Accepting new patients
Prime Orthodontics PLLC Orthodontics and Dentofacial Orthopedics PastSince Aug 11, 2024 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1982430625",
    "addresses": [
        {
            "country_code": "GR",
            "country_name": "Greece",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "3 FINIKOS STREET",
            "city": "ATHENS",
            "state": "GREECE",
            "postal_code": "14564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 NAT TURNER BLVD S",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062998",
            "telephone_number": "757-240-5711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5750 MAIN ST STE 100A",
            "address_purpose": "LOCATION",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "23061",
            "country_code": "US",
            "telephone_number": "804-695-2575",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5000 Foundation St",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231882872",
            "country_code": "US",
            "telephone_number": "757-259-9703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICHELAKI",
        "first_name": "ELEFTHERIA",
        "middle_name": "IRIS",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "VA",
            "license": "0401419040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.