Elloway & Wonenberg, D.D.S., a Professional Dental Corporation

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

47254 Issued in CA

Legal business name

ELLOWAY & WONENBERG, D.D.S., A PROFESSIONAL DENTAL CORPORATION

Practice address

1519 2ND St
Eureka, CA 95501-0701

Phone

(707) 442-1140

Fax

(707) 442-1038

NPI assigned

Mar 8, 2007

Organization subpart

No

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

Authorized official

Name

Kerisa Sue Elloway, D.D.S.

Title

Owner

Phone

(707) 442-1140

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1275664484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1519 2ND ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955010701",
            "telephone_number": "707-442-1140",
            "fax_number": "707-442-1038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 2ND ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955010701",
            "telephone_number": "707-442-1140",
            "fax_number": "707-442-1038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLOWAY & WONENBERG, D.D.S., A PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "ELLOWAY",
        "authorized_official_first_name": "KERISA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-442-1140",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "49706",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "47254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victor Eleazar, RN
• Kathleen J Ellion
• Mark David Elliott, LPCC
• Mark Gregory Ellis, MD
• Stacey L Ellis
• David Rama Elson
• Patricia Ely
• Karen Sue Emerson
• Edward R Emmons, M.D.
• Daisy Eng, MD

• Pediatric Dentistry in Eureka, CA
• Providers in Eureka, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.