Gary Ellenbogen, D.D.S.

General Practice Dentistry · Vienna, VA

Individual Active NPI Reactivated September 11, 2013

NPI number 1770653495

Practice location

8100 Boone Blvd
Vienna, VA 22182-2665
Phone
(703) 734-1095
Fax
(703) 714-9330

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NPI record

NPI
1770653495
Entity type
Individual (Type 1)
Enumeration date
November 9, 2006
Last updated
September 11, 2013
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 5562 VA

About Dr. Ellenbogen

Gary Ellenbogen, D.D.S. is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 8100 Boone Blvd, Vienna, VA 22182-2665. The NPI number 1770653495 was assigned on November 9, 2006 and the record was last updated on September 11, 2013.

Dr. Ellenbogen lists a license in the registry: #5562 (VA) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Gary Ellenbogen, D.D.S.?

The NPI number is 1770653495.

What is the phone number of Dr. Ellenbogen?

The phone number listed for the practice location is (703) 734-1095.

Where is Dr. Ellenbogen located?

8100 Boone Blvd, Vienna, VA 22182-2665.

What is the taxonomy code for Dr. Ellenbogen?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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