Teresa Eileen Ellis, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS8148 Issued in TN

Practice address

1720 West Ave
Suite 106
Crossville, TN 38555-4066

Phone

(931) 784-3007

NPI assigned

Oct 24, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330387200000",
    "number": "1568545119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 WEST AVE",
            "address_2": "SUITE 106",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385554066",
            "telephone_number": "931-484-3007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 WEST AVE",
            "address_2": "SUITE 106",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385554066",
            "telephone_number": "931-784-3007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "TERESA",
        "middle_name": "EILEEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2012-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS8148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5440078",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zachary Ebel, H.I.S. - BC
• Robert Edmonds, LPE
• Susan Stone Edwardson, P.T.
• Judith Ellen Elgin, APRN,BC
• Brooke Elias
• Deborah Anne Ellison, PT
• Megan Leann Elmore, LPN
• Felicia Engebrecht, SLP-CCC
• Elizabeth W England, COTA
• Ashley Eppolito

• General Practice Dentistry in Crossville, TN
• Providers in Crossville, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2012; 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.