Provider Demographics
NPI:1730119157
Name:MCELHANEY, MARY LYNNE (DDS)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:LYNNE
Last Name:MCELHANEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 BRIGHTON DR
Mailing Address - Street 2:
Mailing Address - City:ELON
Mailing Address - State:NC
Mailing Address - Zip Code:27244-8306
Mailing Address - Country:US
Mailing Address - Phone:336-586-0813
Mailing Address - Fax:
Practice Address - Street 1:3008 S CHURCH ST STE B
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5686
Practice Address - Country:US
Practice Address - Phone:336-584-7004
Practice Address - Fax:336-584-3515
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC57331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC50643241OtherAETNA PROVIDER ID
NC95749OtherBCBS PROVIDER ID
NC8995749Medicaid