Ellen Marie Tavarone, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901017253 Issued in MI

Practice address

2060 Division Ave S
Grand Rapids, MI 49507-3029

Phone

(616) 475-8446

Fax

(616) 475-1272

NPI assigned

Dec 4, 2006

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

Enrolled in MI

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

Interoperability endpoints

• Direct secure messaging: ellen.tavarone.1@8492.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/8589/brand/1/csg/1/fhir/r4

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.

• Aaron C. Ford DDS PLLC

  • Dental Clinic/Center
  • Vicksburg, MI
  • NPI 1497605927
  NPD (past)
• Exalta Health

  • Specialist
  • Grand Rapids, MI
  • NPI 1588840854
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1558429605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 DIVISION AVE S",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495073029",
            "telephone_number": "616-475-8446",
            "fax_number": "616-475-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 DIVISION AVE S",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495073029",
            "telephone_number": "616-475-8446",
            "fax_number": "616-475-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVARONE",
        "first_name": "ELLEN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901017253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tatum D. Teeple, Ms, TLLP, PLLC (Tatum D. Teeple, MS, MLP)
• Joann Tatum
• Kristen Tavalieri, DNP, NP, FNP-C
• Erica Marie Tavares, MD
• Amy Tavarez
• Carlos Tavera, MD
• Cierra Brooke Tawney
• Eugene Tay, MD
• Taylor Home Care
• Abigail Taylor

• Dentist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; 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.