Jessica Christine Ellis, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2016001693 Issued in MO

Practice address

12400 E US Highway 40
Independence, MO 64055-5929

Phone

(816) 897-5850

Fax

(816) 897-5851

NPI assigned

Jun 7, 2012

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 names 1

• Dr. Jessica Christine Watkins Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Locations

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.

• Comfort Dental Lees Summit

  • General Practice Dentistry
  • Lees Summit, MO
  • NPI 1386219160
  NPD Authorized official
• South Independence Dental LLC

  • Dentist
  • Independence, MO
  • NPI 1245842202
  NPD
• Sahuarita Modern Dentistry and Orthodontics, LLP

  • General Practice Dentistry
  • Green Valley, AZ
  • NPI 1124304472
  NPD (past)

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1639430440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 NE BEACON AVE",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640868454",
            "telephone_number": "816-521-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12400 E US HIGHWAY 40",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640555929",
            "telephone_number": "816-897-5850",
            "fax_number": "816-897-5851"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18726 S Nogales Hwy",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Green Valley",
            "state": "AZ",
            "postal_code": "856145878",
            "country_code": "US",
            "telephone_number": "520-625-4850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JESSICA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-07",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2016001693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "southindependence@comfortdental.biz",
            "affiliation": "N",
            "endpointDescription": "office email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "office email",
            "address_1": "12400 E US Highway 40",
            "city": "Independence",
            "state": "MO",
            "country_code": "US",
            "postal_code": "640555929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "WATKINS",
            "middle_name": "CHRISTINE",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marcus Justin Ehrhart
• Raashida A El-Scari, LPC
• Elevate Hospice, LLC
• James David Elias, D.D.S.
• Marsha K Elliott
• Stephen C. Ellis, MD
• Gretchen Ellison, R.PH.
• James Russell Ellison, PHARMD
• Lisa Ann Elmore, NBC-HIS
• Jerald E Elrod I, DDS

• General Practice Dentistry in Independence, MO
• Providers in Independence, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.