James Padgett Ellis, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

30.021535 Issued in OH

Practice address

5155 Bradenton Ave
Suite 100
Dublin, OH 43017-7558

Phone

(614) 764-9455

Fax

(614) 526-3745

NPI assigned

Jan 22, 2007

Sex

Male

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 22, 2013 through Oct 22, 2027

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.

• Oral and Facial Surgeons of Ohio

  • Oral and Maxillofacial Surgery (Dentist)
  • Dublin, OH
  • NPI 1043427883
  NPD (past) Authorized official

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699828533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5155 BRADENTON AVE",
            "address_2": "SUITE 100",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430177558",
            "telephone_number": "614-764-9455",
            "fax_number": "614-526-3745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5155 BRADENTON AVE",
            "address_2": "SUITE 100",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430177558",
            "telephone_number": "614-764-9455",
            "fax_number": "614-526-3745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JAMES",
        "middle_name": "PADGETT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30.021535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Elliott
• Sade Elliott
• Yuliza Elliott
• Christy Ellis-Trolian
• Casey Ellis
• Thomas James Ellis, MD
• Pamela Ellwanger-Schmidt, LISW-S
• Amina Elmarghany
• Ahmed Elmi
• Mariah Elrod

• Oral and Maxillofacial Surgery (Dentist) in Dublin, OH
• Providers in Dublin, OH by specialty
• Oral and Maxillofacial Surgery (Dentist) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.