Dr. Gary Ellenbogen , DDS
Dentist - General Practice • Vienna, VA
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Gary Ellenbogen has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Gary Ellenbogen, DDS was a registered Dentist - General Practice practicing in Vienna, VA. Throughout an active medical career spanning 4 years, Dr. Ellenbogen provided care at the practice location at 8100 BOONE BLVD until profile deactivation on 2010-04-28.
Practice Location & Contact Primary Location
8100 Boone Blvd
Vienna, VA 221822665
Specialty Benchmarks & Practice Insights
Comparative analytics for Dentist - General Practice in Vienna, VA
Practicing in Vienna, VA (3535 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 1223G0001X
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Practice Associates & Co-Workers
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Dentist - General Practice
Career & Practice History Timeline
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Record officially reactivated for active practice on September 11, 2013
Registered at 8100 BOONE BLVD, VIENNA, VA 221822665 (Tel: 7037341095)
Registered at 8100 BOONE BLVD, VIENNA, VA 221822665 (Tel: 7037341095)
Recorded as GARY ELLENBOGEN, D.D.S.
Dentist (License #5562 in VA)
Record deactivated on April 28, 2010
First registered as active Individual Practitioner in NPPES Database.
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Mailing Address
8100 Boone Blvd
Vienna, VA 221822665
Phone: 7037341095
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