# ELEVATE ORAL SURGERY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Elevate Oral Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861147993
- **Authorized official:** DR. TAMER ELHADY DMD (GENERAL PARTNER)
- **Authorized official phone:** (703) 980-2475

## Contact information

- **Practice address:** 131 ELDEN ST STE 300, HERNDON, VA 20170-4851
- **Practice address phone:** (703) 689-3900
- **Practice address fax:** (703) 689-3903
- **Mailing address:** 3903 FAIR RIDGE DR STE 215, FAIRFAX, VA 22033-2945

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 02/17/2022
- **Last updated:** 02/17/2022