Robert Stephen Ellis, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1711-76 Issued in MS

Practice address

1434 - Parker Drive
Laurel, MS 39440-1942

Phone

(601) 649-3335

Fax

(601) 426-6318

NPI assigned

Aug 7, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Laurel Oaks Dental Care

  • General Practice Dentistry
  • Laurel, MS
  • NPI 1538218664
  NPD (past)

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218067200000",
    "number": "1124274394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1434 - PARKER DRIVE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394401942",
            "telephone_number": "601-649-3335",
            "fax_number": "601-426-6318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1434 - PARKER DRIVE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394401942",
            "telephone_number": "601-649-3335",
            "fax_number": "601-426-6318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "ROBERT",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-07",
        "last_updated": "2008-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "1711-76",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timorie Edmonds
• Edward Brown Specialty Partners of Mississippi, PLLC
• Edward Robert Cohen
• Alexandra Edwards, NP
• Brandy A Ellis
• Julie Emfinger
• Encore Rehabilitation Inc
• Eplus Oncologics Mississippi, LLC
• Eternity Hospice Inc
• Eunique Visions Counseling Services, LLC

• General Practice Dentistry in Laurel, MS
• Providers in Laurel, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; 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.