Heidi Susan Ellis, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901018715 Issued in MI

Practice address

Naval Postgraduate School
8901 Wisconsin Ave
Bethesda, MD 20889-5602

Phone

(301) 295-0145

NPI assigned

Dec 9, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Heidi Susan Borek Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375660800000",
    "number": "1003891201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL POSTGRADUATE SCHOOL",
            "address_2": "8901 WISCONSIN AVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208895602",
            "telephone_number": "301-295-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL POSTGRADUATE SCHOOL",
            "address_2": "8901 WISCONSIN AVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208895602",
            "telephone_number": "301-295-0145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "HEIDI",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-09",
        "last_updated": "2013-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901018715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "BOREK",
            "middle_name": "SUSAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ritrisha Nicole Ellington
• Jeffrey Scott Elliott, MD
• Eithne Ellis, OTR/L
• Graham Christian Ellis, MD
• Harvey Joe Ellis, CCP,LP
• Linda Ellison-Dejewski, FNP-BC
• Caitlin Marie Elsenbeck, M.D.
• Jane L Elsten, M.D.
• Eric A Elster, MD
• Teresita Elster, CRNA

• General Practice Dentistry in Bethesda, MD
• Providers in Bethesda, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.