GARY ELLENBOGEN D.D.S.
NPI 1770653495
Dentist - General Practice in Vienna, VA

Q: What is Gary Ellenbogen's NPI number?

The NPI number for Gary Ellenbogen is 1770653495. It was assigned to this individual provider in the NPPES registry on November 9, 2006.

Q: What is Gary Ellenbogen's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Gary Ellenbogen was last updated on September 11, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 09, 2006PECOS Enrolled

8100 BOONE BLVD, VIENNA, VA 22182(703) 734-1095(703) 714-9330 Get Directions Write a Review

NPPES record last updated: September 11, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Gary Ellenbogen D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GARY ELLENBOGEN D.D.S. (NPI 1770653495) is an individual general practice provider in Vienna, Virginia, licensed in Virginia (5562) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1770653495

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameGARY ELLENBOGENCredential: D.D.S.

Location Address8100 BOONE BLVDVienna, VA 22182-2665

Mailing Address8100 Boone BlvdVienna, VA 22182-2665 · (703) 734-1095 · Fax (703) 714-9330

Phone(703) 734-1095

Fax(703) 714-9330

Sole ProprietorNo

Enumeration DateNovember 9, 2006

Last NPPES UpdateSeptember 11, 2013

✔ NPI 1770653495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in VA · 5562

Definition

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.

8100 BOONE BLVD, Vienna, VA 22182

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gary Ellenbogen D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22182 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$100.31 typical visit price

range $65.18 – $194.86

Typical copayment $25.07 (range $16.29 – $48.71)

Most-billed visit code 99203

Established Patient

$80.66 typical visit price

range $21.40 – $158.88

Typical copayment $20.16 (range $5.35 – $39.72)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARJAN YOUSEFI, M.D., P.C.

Dermatology

8100 BOONE BLVD, SUITE 250
VIENNA, VA 22182

Fairfax County (703) 255-5070

DENTAL ASSOCIATES

Clinic/Center (Dental)

8100 BOONE BLVD
VIENNA, VA 22182

Fairfax County (703) 269-3150

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gary Ellenbogen's NPI number?

The NPI number for Gary Ellenbogen is 1770653495. It was assigned to this individual provider in the NPPES registry on November 9, 2006.

Where is Gary Ellenbogen located?

Gary Ellenbogen practices at 8100 Boone Blvd, Vienna, VA 22182. The listed phone number is (703) 734-1095.

What is Gary Ellenbogen's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Gary Ellenbogen enrolled in Medicare?

Yes. Gary Ellenbogen is registered in the Medicare PECOS enrollment system.

What insurance does Gary Ellenbogen accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and HRI Dental & Vision and 3 other insurers list Gary Ellenbogen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Gary Ellenbogen was last updated on September 11, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.