J. Scott Ellis, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

12185 Issued in TX

Legal business name

J. SCOTT ELLIS, D.D.S.

Practice address

5615 Old Bullard Rd
Tyler, TX 75703-4306

Phone

(903) 561-3756

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Dr. John Scott Ellis, D.D.S.

Title

President

Phone

(903) 561-3756

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.

• Scott Ellis, DDS

  • Dentist
  • Tyler, TX
  • NPI 1821272931
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457439846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5615 OLD BULLARD RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757034306",
            "telephone_number": "903-561-3756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5615 OLD BULLARD RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757034306",
            "telephone_number": "903-561-3756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. SCOTT ELLIS, D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-561-3756",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "12185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ashlyn Jacinto, SLP
• Kimberly Estella Jacinto, DDS

• Dentist in Tyler, TX
• Providers in Tyler, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.