Provider Demographics
NPI:1760508535
Name:SCHLANG, ELLIOT P (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELLIOT
Middle Name:P
Last Name:SCHLANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 18TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90402-2404
Mailing Address - Country:US
Mailing Address - Phone:310-451-4401
Mailing Address - Fax:
Practice Address - Street 1:6543 TOPANGA CANYON BLVD
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91303-2622
Practice Address - Country:US
Practice Address - Phone:818-883-7979
Practice Address - Fax:818-883-4498
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA243371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice