Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Dr. Gary Ellenbogen , DDS

Dentist - General Practice • Vienna, VA

Active NPI 1770653495 Individual Practitioner Male Practitioner
Practice location in NPPES

8100 Boone Blvd
Vienna, VA 221822665

Call 7037341095 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

8100 Boone Blvd

Vienna, VA 221822665

Telephone 7037341095
Fax 7037149330
Organization at the Same NPPES Address or Phone
Dental Associates Facility NPI 1700905635

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

What Public CMS Data Show

Dentist - General Practice: NPPES taxonomy is a reported classification, not proof of board certification.

Industry payments (Open Payments)

Fewer than 11 payment records totaling $45.89 in 2023

Drug and medical device companies must report certain payments to doctors and some other clinicians to CMS, such as meals, travel, speaking fees or research funding.

These records are submitted by drug and medical device companies, and a reported payment does not necessarily mean the financial relationship is improper.

General: payments not tied to research, such as meals, travel, consulting or speaking fees.

A reported payment does not necessarily mean the financial relationship is improper. Research payments can go to a hospital or university for a study the clinician leads, not to the clinician personally. Clinicians can dispute records with the company that reported them.

Source: CMS Open Payments, program year 2023.

Guide: How to read an Open Payments record

NPI first issued

2006

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Dr. Ellenbogen has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. Ellenbogen as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Vienna and Virginia

60 active clinicians are listed under Dentist - General Practice with a practice address in Vienna, VA (3,366 in Virginia).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Vienna

0% of these 60 clinicians have the CMS telehealth indicator.

0% of these 60 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Open Payments (2023), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments · Program Year 2023
Disclosure Year:

Program year 2023 (payments made January 1 – December 31, 2023): fewer than 11 records totaling $45.89.

Manufacturer Payment Nature Product Type Amount ($)
ZIMVIE INC.
Food and Beverage
In-kind items and services
BELLATEK General $45.89

Source: CMS Open Payments, program year 2023, released June 30, 2026.

Specialties & License Numbers Reported to NPPES

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

License # reported to NPPES VA 5562

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Virginia Department of Health Professions.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

ORDER AND REFERRING ONLY - DENTIST

Medicare Enrollment ID

I20150902000420

Enrollment State Jurisdiction

VA

PECOS Control ID

6800102138

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Not Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
Robert Legonitte , DDO

Dentist - General Practice

NPI 1194899229

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
🔄
NPI Profile Reactivated September 11, 2013

Record officially reactivated for active practice on September 11, 2013

📍
Practice Location (Initial Record) September 11, 2013

Registered at 8100 BOONE BLVD, VIENNA, VA 221822665 (Tel: 7037341095)

📍
Business Mailing Address (Initial Record) September 11, 2013

Registered at 8100 BOONE BLVD, VIENNA, VA 221822665 (Tel: 7037341095)

👤
Provider Name / Credentials (Initial Record) September 11, 2013

Recorded as GARY ELLENBOGEN, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 11, 2013

Dentist (license number reported to NPPES: VA 5562)

⚠️
NPI Profile Deactivated April 28, 2010

NPPES lists this NPI as deactivated as of April 28, 2010; the reason is not published.

🟢
Initial NPI Registration & Enumeration November 09, 2006

First registered as active Individual Practitioner in NPPES Database.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1770653495
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 09, 2006
Last Update: September 11, 2013
Sole Proprietor: No

Other Dentist - General Practices in Vienna

All Dentist - General Practices in Vienna

Mailing Address

8100 Boone Blvd

Vienna, VA 221822665

Phone: 7037341095

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.