Crystal G. Ellis, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14220 Issued in MD

Practice address

8455 Colesville Rd Ste 102
Silver Spring, MD 20910-6363

Phone

(301) 588-0030

Fax

(301) 588-1699

NPI assigned

May 6, 2008

Last updated

Oct 1, 2024By the provider in NPPES

Sex

Female

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

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.

• Federal Hill Dental LLC

  • General Practice Dentistry
  • Baltimore, MD
  • NPI 1174461057
  NPD Authorized official
• Bronxcare Health System

  • Dental Clinic/Center
  • Bronx, NY
  • NPI 1851717219
  NPD (past)

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1407022783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8455 COLESVILLE RD STE 102",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209106363",
            "telephone_number": "301-588-1099",
            "fax_number": "301-588-1699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8455 COLESVILLE RD STE 102",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209106363",
            "telephone_number": "301-588-0030",
            "fax_number": "301-588-1699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "CRYSTAL",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-06",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "14220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elliot R Goldstein MD & Joel R Schulman MD PA
• Ashley Elliott-Adams
• James Anthony Elliott, LCSW-C
• Prema M. Ellis-Jeffrey, MA
• Chauntelle Naomi Hayes Ellis, CPNP
• Hannah Theresa Ellis
• Marjorie Ellis, LCSW-C
• Racquel Ellis, DO
• Vongi Aletha Ellison, P.T.
• Gerard Elonge - Fobia, HHA

• General Practice Dentistry in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.