C Chase Ellinwood DDS LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

C CHASE ELLINWOOD DDS LLC

Practice address

5725 Maplecrest Rd Ste 1
Fort Wayne, IN 46835-4937

Phone

(260) 492-2640

NPI assigned

Dec 9, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Charles Chase Elilnwood, DDS

Title

Member

Phone

(260) 492-2640

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Chase Ellinwood, DDS

  • General Practice Dentistry
  • Fort Wayne, IN
  • NPI 1598322083
  NPD

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1316753916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5725 MAPLECREST RD STE 1",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468354937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5725 MAPLECREST RD STE 1",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468354937",
            "telephone_number": "260-492-2640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C CHASE ELLINWOOD DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "ELILNWOOD",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "CHASE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "260-492-2640",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan Bylett, DO
• Hannah Byrd
• Samone Byrd
• C & D Healthcare Services, LLC
• C & D Healthcare Services, LLC
• C J Pataluch OD PC
• Emmanuel C. Cabe, MD
• Maria Theresa A. Cabe, MD
• Kay Lyn Caccamo, RRT
• Vicki Eileen Caccamo, RPH

• Dental Clinic/Center in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Dental Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.