Provider Demographics
NPI:1265040463
Name:ELANA KORN DDS PLLC
Entity Type:Organization
Organization Name:ELANA KORN DDS PLLC
Other - Org Name:ALLENTOWN DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ELANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KORN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:716-361-0190
Mailing Address - Street 1:349 ELMWOOD AVE.
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14222
Mailing Address - Country:US
Mailing Address - Phone:716-883-9447
Mailing Address - Fax:
Practice Address - Street 1:349 ELMWOOD AVE.
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14222
Practice Address - Country:US
Practice Address - Phone:716-883-9447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-14
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental