Provider Demographics
NPI:1023394541
Name:ELPERIN DDS, PLLC
Entity Type:Organization
Organization Name:ELPERIN DDS, PLLC
Other - Org Name:SUNRISE DENTAL OF ELLENSBURG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ELPERIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:509-790-0080
Mailing Address - Street 1:306 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-3608
Mailing Address - Country:US
Mailing Address - Phone:509-790-0080
Mailing Address - Fax:509-232-7181
Practice Address - Street 1:306 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-3608
Practice Address - Country:US
Practice Address - Phone:509-790-0080
Practice Address - Fax:509-232-7181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60169589122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty