Ryan Ellis, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

104472 Issued in CA

Practice address

31843 Rancho California Rd Ste 300
Temecula, CA 92591-5120

Phone

(951) 676-2613

NPI assigned

Oct 11, 2019

Last updated

Oct 11, 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 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.

• Chu and Watanabe Dental Corporation

  dba Meadows Dental Group

  • General Practice Dentistry
  • Temecula, CA
  • NPI 1205990496
  NPD (past)

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1437791399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38373 APPLEWOOD CT",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925636230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31843 RANCHO CALIFORNIA RD STE 300",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925915120",
            "telephone_number": "951-676-2613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-11",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Ellickson
• Bailey Lynn Elliott
• Shannon Elliott
• Susan Lianne Elliott, APCC
• John G Ellis, M.D.
• Latisha Ellison
• Ayman Elmasri
• Ramsey Elsayed, MD, MS
• Embrace Medical, LLC
• Embracing Your Journey Inc.

• General Practice Dentistry in Temecula, CA
• Providers in Temecula, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.