Eric C Ellingsen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE7903 Issued in WA

Practice address

1215 N McDonald Rd
Suite 203
Spokane Valley, WA 99216-1048

Phone

(509) 924-2866

Fax

(509) 924-8311

NPI assigned

Apr 10, 2007

Sex

Male

Sole proprietor

No

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

Enrolled in WA

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 and National Provider Directory roles.

• Ellingsen Henneberg PLLC

  • Dental Clinic/Center
  • Spokane, WA
  • NPI 1215535695
  NPD Authorized official
• Ellingsen Henneberg PLLC

  • Dentist
  • Spokane, WA
  • NPI 1841845211
  NPD Authorized official

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245453265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 N MCDONALD RD",
            "address_2": "SUITE 203",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161048",
            "telephone_number": "509-924-2866",
            "fax_number": "509-924-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 N MCDONALD RD",
            "address_2": "SUITE 203",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161048",
            "telephone_number": "509-924-2866",
            "fax_number": "509-924-8311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLINGSEN",
        "first_name": "ERIC",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE7903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Lee Ellertsen, CDP
• Ellingsen -Paxton DDS PS
• Ellingsen and Denison Endodontics, PLLC
• Ellingsen Endodontics PLLC
• Elise Kathryn Ellingsen Miller, DDS, MSD
• Lisa Ann Ellingsen, DDS MS
• Michelle A Ellingsen, DDS,MSD
• Richard C Ellingsen
• Christopher Elliott
• Felicia Irene Ellis

• General Practice Dentistry in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• General Practice Dentistry in Washington

• 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.
• 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.