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NPI 1407529134

NPI 1407529134 : ELENA KAN DDS : BOSTON, MA

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General NPI Number Information
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    NPI Number           |    1407529134
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    Entity Type          |    Individual 
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    Provider Name        |    ELENA KAN DDS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/28/2021
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    Last Update Date     |    11/18/2025
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Provider Practice Location Address
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    Address Line         |    188 LONGWOOD AVE 
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    City                 |    BOSTON
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    State                |    MA
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    Zip                  |    02115-5819
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    Country              |    US
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    Telephone            |    617-432-1434
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    188 LONGWOOD AVE 
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    City                 |    BOSTON
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    State                |    MA
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    Zip                  |    02115-5819
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223P0700X
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    Taxonomy Name        |    Prosthodontics
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    License Number       |    063909-01
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    License Number State |    NY
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