ELITE ENDODONTICS (NPI# 1336654102) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336654102 |
| Entity Type | Organization |
| Organization Name | ELITE ENDODONTICS |
| Practice Address |
1135 S Lapeer Rd Ste A Lake Orion MI 48360-1432 |
| Mailing Address |
6965 Oakhurst Ridge Rd Clarkston MI 48348-5053 |
| Practice Telephone | 6165022846 |
| Enumeration Date | 2017-12-02 |
| Last Update Date | 2017-12-02 |
| Authorized Official Name | DR. DREW WAYNE MOELLER (ENDODONTIST) |
| Authorized Official Telephone | 6165022846 |
| Authorized Official Credential | DDS, MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
2901020373 | MI | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063831709 | Elite Endodontics | Clinic/Center | 338 Ne 181st Ave, Portland, OR 97230-6618 | 2014-04-09 |
| 1275163099 | Elite Endodontics | Dentist | 6111 N Davis Hwy Ste B, Pensacola, FL 32504-6913 | 2020-01-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | ELITE ENDODONTICS, LLC | 338 Ne 181st Avenue, Portland, OR 97230 |
| Street Address |
1135 S LAPEER RD STE A |
| City | LAKE ORION |
| State | MI |
| Zip Code | 48360-1432 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124409446 | Kyle Vires | Licensed Practical Nurse | 2271 Geyer Ct, Lake Orion, MI 48360 | 2015-06-11 |
| 1871931592 | Ihsan Asbahi | Anesthesiology | 1234 S Lapeer Rd, Lake Orion, MI 48360 | 2013-06-05 |
| 1205119567 | Michigan Bone and Joint Center | Orthopaedic Surgery | 1251 S. Lapeer Rd., Suite #102, Lake Orion, MI 48360 | 2011-09-23 |
| 1629226139 | Travis L Summerville | Physical Therapist | 1298 Walloon Way, Lake Orion, MI 48360 | 2008-09-09 |
| 1982878609 | Audrey Vizzaccaro | Physician Assistant | 1261 South Lapeer Rd, Ste 201, Lake Orion, MI 48360 | 2008-04-14 |
| 1881872265 | H & L Drugs Inc | Durable Medical Equipment & Medical Supplies | 1455 S Lapeer, Suite 101, Lake Orion, MI 48360 | 2008-02-07 |
| 1598952129 | Oakland Psychological Clinic, P.C. | Counselor | 1455 S Lapeer Rd Ste 175n, Lake Orion, MI 48360 | 2007-09-27 |
| 1700098704 | Laura Elizabeth Salome | Audiologist | 1176 S. Lapeer Rd, Lake Orion, MI 48360 | 2007-05-04 |
| 1780743658 | Frank James Iulianelli | Chiropractor | 2523 South Lapeer Road, Lake Orion, MI 48360 | 2006-12-07 |
| 1942377122 | James C Komendera Dds PC | Dentist | 1135 S Lapeer Rd, Lake Orion, MI 48360 | 2006-11-30 |
| Find all providers in zip 48360 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225647514 | Drs Mesh, P.C. | Dentist | 15555 Silver Parkway, Fenton, MI 48430 | 2020-07-23 |
| 1285252874 | Plymouth Endodontics | Dentist | 9416 S Main St Ste 212, Plymouth, MI 48170-4148 | 2020-07-09 |
| 1578192712 | Rabban-acho Dental Pllc | Dentist | 38550 Garfield Rd Ste C, Clinton Township, MI 48038-3406 | 2020-04-08 |
| 1700411378 | Macomb Endodontics | Dentist | 51817 Gratiot Ave, Chesterfield, MI 48051-2014 | 2020-03-04 |
| 1861950701 | Garfield Road Dental- 2 | Dentist | 15401 Dix Toledo Rd, Southgate, MI 48195-2662 | 2019-03-11 |
| 1255719456 | Norton Shores Dental PC | Dentist | 837 Seminole Rd Ste 100, Norton Shores, MI 49441-6734 | 2015-05-08 |
| 1396186292 | Ryan Brooks Mcmahan | Dentist | 400 W Main St Ste 106, Gaylord, MI 49735-1870 | 2013-07-09 |
| 1124461579 | Sarmad Mazin Alyas | Dentist | 37641 Pembroke Ave, Livonia, MI 48152-1050 | 2013-04-16 |
| 1568704468 | Arnold Harry Gartner | Dentist | 1547 W Long Lake Rd, Bloomfield Hills, MI 48302-1342 | 2013-03-19 |
| 1811258221 | Kari Brodsky | Dentist | 50055 Van Dyke Ave, Shelby Township, MI 48317-1352 | 2012-06-01 |
| Find all providers with the same taxonomy | ||||
| City | LAKE ORION |
| Zip Code | 48360 |
Please comment or provide details below to improve the information on ELITE ENDODONTICS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.