Alyssa Ellsworth, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

00202776 Issued in CO

Practice address

4150 Darley Ave Ste 3
Boulder, CO 80305-6537

Phone

(303) 499-0013

NPI assigned

Apr 27, 2015

Sex

Female

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

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Priya Uppal DDS PLLC

  • Dentist
  • Boulder, CO
  • NPI 1700528973
  NPD (past)

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

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1508243775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2258 W 35TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802112908",
            "telephone_number": "314-809-9609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 DARLEY AVE STE 3",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803056537",
            "telephone_number": "303-499-0013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10000 Commons St",
            "address_purpose": "LOCATION",
            "city": "Lone Tree",
            "state": "CO",
            "postal_code": "801245501",
            "country_code": "US",
            "telephone_number": "303-999-4578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "ALYSSA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-27",
        "last_updated": "2019-01-09",
        "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": "CO",
            "license": "00202776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Elliott
• Gregory L Ellis, OD
• Heath Ellis
• Jeremy Ellis
• Mary Ellis, LAC
• C David Elm, PH.D.
• Ashlee Deann Elmont, OD
• Rachael Elrod-Martinez, LAC
• Mary G Elsea, DC
• Angela Ely

• General Practice Dentistry in Boulder, CO
• Providers in Boulder, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.