Provider Demographics
NPI:1053861799
Name:ELEVATED ORAL & IMPLANT SURGERY, P.C.
Entity Type:Organization
Organization Name:ELEVATED ORAL & IMPLANT SURGERY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:DEISROTH
Authorized Official - Last Name:BARRONER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:724-260-5009
Mailing Address - Street 1:1131 BOYCE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:UPPER ST CLAIR
Mailing Address - State:PA
Mailing Address - Zip Code:15241-3927
Mailing Address - Country:US
Mailing Address - Phone:724-260-5009
Mailing Address - Fax:724-299-3154
Practice Address - Street 1:1131 BOYCE RD
Practice Address - Street 2:SUITE A
Practice Address - City:UPPER ST CLAIR
Practice Address - State:PA
Practice Address - Zip Code:15241-3927
Practice Address - Country:US
Practice Address - Phone:724-260-5009
Practice Address - Fax:724-299-3154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-05
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty