Elena Kan, D.D.S., M.S.
Dentist, Endodontics in St Petersburg, FL. Individual provider (NPI-1).
NPI number1407105083
StatusActive
Last updated in NPPESSep 8, 2023
Details
- NPI
- 1407105083
- Entity type
- Individual (NPI-1)
- Name
- Elena Kan
- Credential
- D.D.S., M.S.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 29, 2012
- Certification date
- Sep 8, 2023
- Last updated
- Sep 8, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · ORDER AND REFERRING ONLY - DENTIST
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223E0200X | Dentist, Endodontics | DN21445 | FL | Yes |
| 122300000X | Dentist | DN21445 | FL |
Practice location
560 Jackson St N Ste 250St Petersburg, FL 33705-1449
Phone 727-289-2981 · Fax 727-280-5225
Mailing address
560 Jackson St N Ste 250St Petersburg, FL 33705-1449
Phone 727-289-2981 · Fax 727-280-5225
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 10 Endodontics providers in St Petersburg · All 8,700 providers in St Petersburg
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