Active NPI
Jennifer Emma Ellefson, D.D.S.
- Dentist
- Harker Heights, TX
National Provider Identifier
1194008581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 19279
- Practice address
- 600 Indian TRL
Ste. 202
Harker Heights, TX 76548-1312 - Phone
- (254) 699-7757
- NPI assigned
- Sep 22, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 19279 | TX | Primary |
Addresses
Primary practice location
600 Indian TRL
Ste. 202
Harker Heights, TX 76548-1312
Mailing address
1800 McGinnis CT
Harker Heights, TX 76548-8033
Phone (254) 698-7062
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
| License | State | Type | Specialty |
|---|---|---|---|
| 19279 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316649600000",
"number": "1194008581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 MCGINNIS CT",
"city": "HARKER HEIGHTS",
"state": "TX",
"postal_code": "765488033",
"telephone_number": "254-698-7062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 INDIAN TRL",
"address_2": "STE. 202",
"city": "HARKER HEIGHTS",
"state": "TX",
"postal_code": "765481312",
"telephone_number": "254-699-7757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLEFSON",
"first_name": "JENNIFER",
"middle_name": "EMMA",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-22",
"last_updated": "2011-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "19279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harker Heights, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.