Ellen J Son, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN.00203109 Issued in CO

Practice address

1250 Valley View Dr
Delta, CO 81416-3138

Phone

(970) 874-8981

Fax

(855) 299-7586

NPI assigned

Oct 31, 2007

Last updated

Apr 26, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Olathe Community Clinic Inc

  dba River Valley Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Olathe, CO
  • NPI 1770834244
  Medicare reassignment NPD
• Olathe Community Clinic Inc

  dba River Valley Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Delta, CO
  • NPI 1558886218
  NPD
• Brandywine Dental Services Group

  • General Practice Dentistry
  • Glen Mills, PA
  • NPI 1588864631
  NPD (past)

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1225217714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 592",
            "city": "OLATHE",
            "state": "CO",
            "postal_code": "814250592",
            "telephone_number": "970-323-6141",
            "fax_number": "855-299-8071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 VALLEY VIEW DR",
            "city": "DELTA",
            "state": "CO",
            "postal_code": "814163138",
            "telephone_number": "970-874-8981",
            "fax_number": "855-299-7586"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 Rio Grande Ave",
            "address_purpose": "LOCATION",
            "city": "Montrose",
            "state": "CO",
            "postal_code": "814014831",
            "country_code": "US",
            "telephone_number": "970-497-3333",
            "fax_number": "855-299-7837",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "308 Main St.",
            "address_purpose": "LOCATION",
            "city": "Olathe",
            "state": "CO",
            "postal_code": "81425",
            "country_code": "US",
            "telephone_number": "970-323-6141",
            "fax_number": "855-299-8071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SON",
        "first_name": "ELLEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-31",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS037149",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00203109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Delta, CO
• Providers in Delta, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.