Scott James Elliott, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN26522 Issued in FL

Practice address

7768 Ozark Dr Ste 200
Jacksonville, FL 32256-5891

Phone

(904) 442-6000

NPI assigned

Jul 31, 2020

Last updated

Oct 7, 2022By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Professional Dental Alliance of Jacksonville Ozark, PLLC

  • General Practice Dentistry
  • Jacksonville, FL
  • NPI 1861042541
  NPD

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

{
    "created_epoch": "1596153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1336759794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 WINDWALKER DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320921958",
            "telephone_number": "407-319-5495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7768 OZARK DR STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322565891",
            "telephone_number": "904-442-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "SCOTT",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-31",
        "last_updated": "2022-10-07",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN26522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Laraine Elliott, PHARMD
• Latoya Nicole Elliott, PSYD
• Leslie Elliott, LMT, CNMT, BAS
• Michelle C Elliott, APRN
• Scott Elliott, BCAP, NCAC II
• William Rudolph Elliott, RPH
• Ellis Pediatrics, PLLC
• Joni A. Ellis-Hughes, RN, BSN, CCRN, CRNI
• Ellis-Moore Coroporation (JumpStart Pediatrics)
• Ellis-Moore Coroporation (JumpStart Pediatrics)

• Dentist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.