Individual provider Active NPI

Bita Ashley Ellis, D.D.S.

  • General Practice Dentistry
  • Burke, VA
National Provider Identifier
1154545747
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401-411106 Issued in VA
Practice address
Sunshine Dentists
6035 Burble Centre Pkwy Suite #260
Burke, VA 22015
Phone
(703) 978-1446
Fax
(703) 715-9229
NPI assigned
Apr 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401-411106 VA Primary

Addresses

Primary practice location

Sunshine Dentists
6035 Burble Centre Pkwy Suite #260
Burke, VA 22015

Mailing address

Sunshine Dentists
6035 Burble Centre Pkwy Suite #260
Burke, VA 22015
Phone (703) 978-1446

Other identifiers 1

IdentifierTypeStateIssuer
0401-411106OtherVAVA. DENTAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401-411106VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1154545747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SUNSHINE DENTISTS",
            "address_2": "6035 BURBLE CENTRE PKWY SUITE #260",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "22015",
            "telephone_number": "703-978-1446",
            "fax_number": "703-715-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SUNSHINE DENTISTS",
            "address_2": "6035 BURBLE CENTRE PKWY SUITE #260",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "22015",
            "telephone_number": "703-978-1446",
            "fax_number": "703-715-9229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "BITA",
        "middle_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401-411106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA. DENTAL LICENSE",
            "identifier": "0401-411106",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.