Ellis Tooth Fairy PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ELLIS TOOTH FAIRY PLLC

Practice address

2725 Ellis Ave
Fort Worth, TX 76164-7106

Phone

(646) 262-6648

Fax

(646) 262-6648

NPI assigned

May 20, 2024

Organization subpart

No

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

Authorized official

Name

Yuexi Chen, DDSNPI 1912516840

Title

Mananger

Phone

(646) 262-6648

Specialties & licenses 1

Addresses

Other names 1

• ellis dental Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Yuexi Chen, DDS

  • Dentist
  • Carrollton, TX
  • NPI 1912516840
  NPD Authorized official

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1063251171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12070 BROWNWOOD DR",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750358860",
            "telephone_number": "646-262-6648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 ELLIS AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761647106",
            "telephone_number": "646-262-6648",
            "fax_number": "646-262-6648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIS TOOTH FAIRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "YUEXI",
        "authorized_official_title_or_position": "MANANGER",
        "authorized_official_telephone_number": "646-262-6648",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ellis dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissa S Elliott, LMSW, LCDC, CADC II
• Peter J Elliott, MD
• Seth Elliott, D.C.
• Shannon Murphy Elliott, M.S., CCC-SLP
• Ellis Dental LLC
• Chandra Ellis, RN
• Christine R Ellis, MD
• Deborah W Ellis, CRNA
• Debra Kay Ellis, LPC, LBSW,ACBSW
• Eddie Ellis

• General Practice Dentistry in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.