PHILLIP J ELASSAL DDS PLLC (NPI# 1053959247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053959247 |
| Entity Type | Organization |
| Organization Name | PHILLIP J ELASSAL DDS PLLC |
| Practice Address |
1601 Sw 89th Street #g500 Oklahoma City OK 73159 |
| Mailing Address |
Po Box 890910 Oklahoma City OK 73189 |
| Practice Telephone | 4056820609 |
| Practice Fax Number | 4056822921 |
| Mailing Telephone | 4056820609 |
| Mailing Fax Number | 4056822921 |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2019-12-18 |
| Authorized Official Name | PHILLIP JAMES ELASSAL (DENTIST) |
| Authorized Official Telephone | 4056820609 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
1601 SW 89TH STREET #G500 |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346849528 | Mel Vision LLC | Optometrist | 1413 W Interstate 240 Service Rd, Suite E, Oklahoma City, OK 73159 | 2020-10-20 |
| 1629573407 | Carrie Lynn Sanchez | Case Manager/Care Coordinator | 2604 Sw 92nd Street, Oklahoma City, OK 73159 | 2018-03-26 |
| 1407368038 | Deborah Dorton | Psychologist | Okc Va Hcs (111a), 921 Ne 13th St, Oklahoma City, OK 73159 | 2017-11-06 |
| 1366969933 | Matthew Lewis Hearne | Case Manager/Care Coordinator | 7504 S Country Club Dr, Apt 105, Oklahoma City, OK 73159 | 2017-08-24 |
| 1043766405 | Pro Hearing, LLC | Clinic/Center | 10404 S Pennsylvania Ave, Oklahoma City, OK 73159 | 2016-08-26 |
| 1952764169 | Doc LLC | Orthopaedic Surgery | 3130 Sw 89th St Ste 200e, Oklahoma City, OK 73159 | 2016-04-04 |
| 1235511288 | Anusha Koneru | Dentist | 1610 W Interstate 240 Service Road, Oklahoma City, OK 73159 | 2015-06-26 |
| 1114347069 | Crystal A Dockery | Family Medicine | 3212 Sw 89th St Ste 100, Oklahoma City, OK 73159 | 2014-04-18 |
| 1790121440 | Kimberly Anne Dyer | Occupational Therapy Assistant | 5725 S Ross, Oklahoma City, OK 73159 | 2013-05-21 |
| 1467898114 | Tammy L Neher | Physical Therapy Assistant | 5725 S. Ross, Oklahoma City, OK 73159 | 2013-05-21 |
| Find all providers in zip 73159 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063041275 | Fleming Dental Co Pllc | Clinic/Center | 13316 S Western Ave Ste B, Oklahoma City, OK 73170-7309 | 2020-04-08 |
| 1578103743 | Dental Surgery Center of Midwest City | Clinic/Center | 9060 Harmony Dr Ste E, Oklahoma City, OK 73130-6253 | 2020-01-15 |
| 1558902874 | Insight Dental and Implants | Clinic/Center | 3906 Nw 10th St Ste B, Oklahoma City, OK 73107-6060 | 2019-10-08 |
| 1225683311 | I240 Dental | Clinic/Center | 1506 W I 240 Service Rd, Oklahoma City, OK 73159-4126 | 2019-08-06 |
| 1861058877 | Dental Depot of 63rd & Nw Expressway, Pllc | Clinic/Center | 4025 Nw 63rd Street, Oklahoma City, OK 73116 | 2019-05-15 |
| 1285100339 | Moore Dentistry & Braces | Clinic/Center | 1530 Sw 119th St Unit 108, Oklahoma City, OK 73170-4938 | 2018-10-16 |
| 1295254068 | Sih Oklahoma PC | Clinic/Center | 1325 N Walker Ave 547, Oklahoma City, OK 73103-6405 | 2017-09-13 |
| 1851811293 | Red Dirt Orthodontics Pllc | Clinic/Center | 5940 Nw Expressway # 100, Oklahoma City, OK 73132-5101 | 2017-06-27 |
| 1518494384 | Uptown Smiles Pllc | Clinic/Center | 601 Nw 23rd St, Suite 200, Oklahoma City, OK 73103-1415 | 2017-05-11 |
| 1518250265 | Legacy Family Dentist, Pllc. | Clinic/Center | 8470 Nw Expressway, Oklahoma City, OK 73162-6009 | 2011-05-26 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73159 |
Please comment or provide details below to improve the information on PHILLIP J ELASSAL DDS PLLC.
| 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.