Provider Demographics
NPI:1548298144
Name:MCELROY, SCOTT DARREN (DDS)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:DARREN
Last Name:MCELROY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5122 DAMIANO CT
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-4135
Mailing Address - Country:US
Mailing Address - Phone:925-469-9620
Mailing Address - Fax:
Practice Address - Street 1:2301 CAMINO RAMON
Practice Address - Street 2:STE 288
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4440
Practice Address - Country:US
Practice Address - Phone:925-242-0180
Practice Address - Fax:925-242-0181
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA427441223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics