MEDICARE: ALEXEI ELPERIN DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN 15966	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295930063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXEI ELPERIN DMD

Provider Business Mailing Address
First Line	:	251 174TH ST APT 2308
Second Line	:
City	:	SUNNY ISLES BEACH
State	:	FL
Zip	:	33160-3360
Country	:	US
Telephone Number	:	305-527-7712
Fax Number	:

Provider Business Practice Location Address
First Line	:	16209 NE 13TH AVE
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4607
Country	:	US
Telephone Number	:	305-940-9888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2007
Last Update Date	:	07/08/2007

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