Organization Active NPI

Ronald H. Ellingsen, DDS, MSD, PS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Spokane, WA
National Provider Identifier
1215482757
Registry record updated Aug 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DE00006353 Issued in WA
Legal business name
RONALD H. ELLINGSEN, DDS, MSD, PS
Practice address
9915 N Division St
Spokane, WA 99218-1303
Phone
(509) 467-2606
Fax
(509) 465-8272
NPI assigned
Aug 24, 2016
Last updated
Aug 24, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2016

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

Authorized official

Name
Mrs. Patricia A Ellingsen
Title
Sec/Treasurer
Phone
(509) 467-2606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DE00006353 WA Primary

Addresses

Primary practice location

9915 N Division St
Spokane, WA 99218-1303

Mailing address

9915 N Division St
Spokane, WA 99218-1303
Phone (509) 467-2606

Other identifiers 1

IdentifierTypeStateIssuer
5033576MedicaidWA

National Provider Directory

National Provider Directory

Locations

9915 N Division St
Spokane, WA 99218
Phone (509) 467-2606

NPI Registry JSON

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471996800000",
    "number": "1215482757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9915 N DIVISION ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181303",
            "telephone_number": "509-467-2606",
            "fax_number": "509-465-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9915 N DIVISION ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181303",
            "telephone_number": "509-467-2606",
            "fax_number": "509-465-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD H. ELLINGSEN, DDS, MSD, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-24",
        "last_updated": "2016-08-24",
        "status": "A",
        "authorized_official_last_name": "ELLINGSEN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SEC/TREASURER",
        "authorized_official_telephone_number": "509-467-2606",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "DE00006353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5033576",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2016; 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.