Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GARY ELLENBOGEN, D.D.S.
DeactivatedGARY ELLENBOGEN, D.D.S. is a General Dentistry healthcare provider located in VIENNA, Virginia. NPI 1770653495 is deactivated in the NPPES registry. Verify at CMS.
General Dentistry · VIENNA, VA
This NPI has been deactivated.
The record was deactivated on April 28, 2010.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1770653495
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 9, 2006 (3.4657534246575 yrs)
- Last Updated
- Sep 11, 2013
- Deactivated
- Apr 28, 2010
- License
-
5562 (VA)
Practice Information
- Address
-
8100 BOONE BLVDVIENNA, VA, 221822665Browse VA providers · Browse ZIP 22182
- Phone
- 7037341095
- Fax
- 7037149330
- Primary Specialty
-
General Dentistry
1223G0001X
Other General Dentistry Providers in VIENNA, VA
| Name | Credential | NPI |
|---|---|---|
| DR. HOWARD THOMAS LENZ JR. | DDS | 1255334199 |
| DR. BARRY DUANE LAURENT | DDS | 1255354056 |
| DR. HOLLIE BLEVINS STACK | DDS | 1366458143 |
| DR. WILLIAM H. WEINKAM JR. | DDS | 1407868490 |
| DR. ROLAND EDWARD STECHER | D.D.S. | 1578655684 |
| DR. BARRY S RUDOLPH | D.D.S. | 1699855221 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.