Dafne Itati Ellis, DMD MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

00201834 Issued in CO

Practice address

255 Union Blvd Ste 430
Lakewood, CO 80228-1834

Phone

(303) 988-2780

Fax

(303) 988-2783

NPI assigned

Aug 11, 2010

Last updated

May 19, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lakewood Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lakewood, CO
  • NPI 1659783470
  NPD (past) Authorized official
• Modern Dental Profesionals Co PC

  dba Brightn Now Dental - Castle Rock

  • General Practice Dentistry
  • Castle Rock, CO
  • NPI 1124409552
  NPD (past)

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1306151626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 UNION BLVD STE 430",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281834",
            "telephone_number": "303-988-2780",
            "fax_number": "352-273-9671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 UNION BLVD STE 430",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281834",
            "telephone_number": "303-988-2780",
            "fax_number": "303-988-2783"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "188 Founders Pkwy Ste A",
            "address_purpose": "LOCATION",
            "city": "Castle Rock",
            "state": "CO",
            "postal_code": "801047519",
            "country_code": "US",
            "telephone_number": "303-688-0252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "DAFNE",
        "middle_name": "ITATI",
        "name_prefix": "Dr.",
        "credential": "DMD MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-11",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN18641",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CO",
            "license": "00201834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daisha Elliott
• Jennifer Renee Elliott, RBT
• Mary B Elliott, RN
• Carrie L Ellis, LPC
• Clarence V Ellis, MD
• Mechelle Renee Ellis, MA
• Tracy Ellis
• Donna Ruth Ellsworth, MSN, NP
• Greg Ellsworth, RN
• Mary Adel Elmasri, M.D

• Orthodontics and Dentofacial Orthopedics Dentistry in Lakewood, CO
• Providers in Lakewood, CO by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; 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.