Elizabeth Baker Bortell, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

0401410308 Issued in VA

Practice address

2924 Brook Rd
Credentialing Dept
Richmond, VA 23220-1215

Phone

(804) 321-7474

Fax

(804) 228-5970

NPI assigned

Oct 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284940800000",
    "number": "1992894190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2924 BROOK RD",
            "address_2": "CREDENTIALING DEPT",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232201215",
            "telephone_number": "804-321-7474",
            "fax_number": "804-228-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2924 BROOK RD",
            "address_2": "CREDENTIALING DEPT",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232201215",
            "telephone_number": "804-321-7474",
            "fax_number": "804-228-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORTELL",
        "first_name": "ELIZABETH",
        "middle_name": "BAKER",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2010-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401410308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "0401410308",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shawn M Borich, M.D.
• Danielle Maria Boris
• Born to Be Great II
• Joshua W Boron, DO
• Anna Christine Borrelli, LCSW
• Joseph F Borzelleca Jr., M.D.
• Melanie A Bosco, MA, LPA, LPC, LCMHC
• Joseph Robert Bosley, DMD
• Nicole Boss
• Amy L Bostaph, CRNA

• Pediatric Dentistry in Richmond, VA
• Providers in Richmond, VA by specialty
• Pediatric Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; 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.

Verify at the official NPI Registry.