Emerson Russell Ehlis, DMD, MSD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

2171 Issued in ND

Practice address

4710 Amber Valley Pkwy S
Suite B
Fargo, ND 58104-8694

Phone

(701) 293-5300

NPI assigned

Nov 18, 2009

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• West & Ehlis Orthodontic Management Company LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Fargo, ND
  • NPI 1609250620
  NPD (past)

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

{
    "created_epoch": "1258502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412294400000",
    "number": "1295063980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 AMBER VALLEY PKWY S",
            "address_2": "SUITE B",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048694",
            "telephone_number": "701-293-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 AMBER VALLEY PKWY S",
            "address_2": "SUITE B",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048694",
            "telephone_number": "701-293-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHLIS",
        "first_name": "EMERSON",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "DMD, MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-18",
        "last_updated": "2014-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "390200000X",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "ND",
            "license": "2171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krista Ann Egan, DNP, FNP-C
• Layne Egan, MD
• Ella Kaye Eggers
• Mark T. Eginton, MD
• Neil Carlos Ehlers
• Renai D Ehrichs, NP
• Sydney Ehrlin
• Dallas Ehrmantraut, PT, DPT
• Alyssa Eichhorn
• John Patrick Eickman, M.D.

• Orthodontics and Dentofacial Orthopedics Dentistry in Fargo, ND
• Providers in Fargo, ND by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; 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.