David Alan Ellsworth, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

18740 Issued in MI

Practice address

523 W Jefferson St
Petoskey, MI 49770-2271

Phone

(231) 347-8899

NPI assigned

Nov 6, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Harbor Pointe Dental

  • Dentist
  • Petoskey, MI
  • NPI 1649495995
  NPD (past) Authorized official

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1184804221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 W JEFFERSON ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702271",
            "telephone_number": "231-347-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 W JEFFERSON ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702271",
            "telephone_number": "231-347-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-06",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "18740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Francis Ehrnst, D.C.
• Elevate Medical Spa LLC
• Elite Movement Chiropractic Clinic PLC
• Amy-Lynn Ruth Ellenberger, LMT
• Monica Lorraine Elliott
• Walter Emling, RPH
• Margaret-Anne Endlein, DPT, ATC
• Deanna Marie Engelhart, FNP-C
• Max Harris Engelman, OD
• Katelyn Engler

• General Practice Dentistry in Petoskey, MI
• Providers in Petoskey, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; 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.