Justin Kade Ellis

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10989 Issued in TN

Practice address

343 Franklin Rd Ste 103
Brentwood, TN 37027

Phone

(615) 343-1313

NPI assigned

Apr 4, 2019

Last updated

Jun 28, 2019By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1356803712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 FRANKLIN RD STE 103",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275250",
            "telephone_number": "615-343-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 FRANKLIN RD STE 103",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "37027",
            "telephone_number": "615-343-1313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Florida Ave",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701192715",
            "country_code": "US",
            "telephone_number": "504-619-8700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "343 Franklin Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Brentwood",
            "state": "TN",
            "postal_code": "37027",
            "country_code": "US",
            "telephone_number": "615-343-1313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JUSTIN",
        "middle_name": "KADE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-04",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "10989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Lee Ellington
• Anne Elliott, PMHNP
• Eva Marie Elliott, APRN
• Dustin Smith Ellis
• Jordan Marie Ellis, FNP-C
• Ryan V Ellsworth
• Ashley Bearden Elmquist, ED.S.
• Emmanuel Etaye Emakpo, CNIM
• Jovanna Simon Emerson, PH.D.
• Lori D Emerson, MD

• General Practice Dentistry in Brentwood, TN
• Providers in Brentwood, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; 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.