Ellis Dental Care

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5098 Issued in LA

Legal business name

ELLIS DENTAL CARE

Practice address

17583 Old Jefferson Hwy
Prairieville, LA 70769-3930

Phone

(225) 673-2200

Fax

(225) 673-2210

NPI assigned

Aug 20, 2006

Last updated

Feb 10, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David Michael Ellis, DDSNPI 1548426448

Title

Dentist/Owner

Phone

(225) 673-2200

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Michael Ellis, D.D.S.

  • General Practice Dentistry
  • Prairieville, LA
  • NPI 1548426448
  NPD (past) Authorized official

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423526400000",
    "number": "1710092937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17583 OLD JEFFERSON HWY",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707693930",
            "telephone_number": "225-673-2200",
            "fax_number": "225-673-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17583 OLD JEFFERSON HWY",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707693930",
            "telephone_number": "225-673-2200",
            "fax_number": "225-673-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIS DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2015-02-10",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "225-673-2200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tacia Eddie
• Shelby Lynn Edmonston, BCBA, LBA
• Adrianne Netterville Edmundson, M.D.
• Amber Nicole Edwards
• Egt Counseling & Consulting Services, LLC
• David Michael Ellis, D.D.S.
• Emerald Medical Supply
• Misty Entremont
• Essential Occupational Health and Safety V, LLC
• Brett A Evans

• General Practice Dentistry in Prairieville, LA
• Providers in Prairieville, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2015; 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.