Virginia Herin Ellis, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DDS48825 Issued in CA

Practice address

1855 San Miguel Drive
Suite #31
Walnut Creek, CA 94596-5214

Phone

(925) 935-2700

Fax

(925) 935-0268

NPI assigned

Mar 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Virginia Herin Luk Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225167182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 SUTTON CIRCLE",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "94506",
            "telephone_number": "925-648-7442",
            "fax_number": "925-648-7442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 SAN MIGUEL DRIVE",
            "address_2": "SUITE #31",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965214",
            "telephone_number": "925-935-2700",
            "fax_number": "925-935-0268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "VIRGINIA",
        "middle_name": "HERIN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS48825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIRGINIA",
            "last_name": "LUK",
            "middle_name": "HERIN",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anne Elle, RN, IBCLC
• Auben Lin Elliott, PHD
• Olivia Joy Elliott
• Meyata Ellis
• Ron Ray Ellis, PH. D.
• Jackson Ellman-Horvath
• Eman Elmi, DPM
• Kristen Elms, HIGH SCHOOL DIPLOMA
• Patti Rose Dibeme Elong
• Phyllis R. Emanuel, PHYSICAL THERAPIST

• Dentist in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.