Ellen Rudolph Jarvis, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-0006947-C Issued in AL

Practice address

3200 Sycamore CT. Suite 1-C
Columbus, IN 47203

Phone

(812) 379-9211

NPI assigned

Mar 22, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Dee Family Dental LLC

  • General Practice Dentistry
  • Columbus, IN
  • NPI 1972269421
  NPD (past)

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1710003231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 SYCAMORE CT. SUITE 1-C",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "47203",
            "telephone_number": "812-379-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 SYCAMORE CT. SUITE 1-C",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "47203",
            "telephone_number": "812-379-9211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOLPH JARVIS",
        "first_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12010901A",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010901A",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "D-0006947-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa S Rouse
• Stori A Roy
• Patricia M Rubino, NP
• Carla Rae Ruch, PT
• Sierra Ruddick, RBT
• William I Rudolph
• Evan T Russell, MD
• Victoria Russell
• Xena Russell, RBT
• Kelsey Lynne Russo, PT

• General Practice Dentistry in Columbus, IN
• Providers in Columbus, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.