Elie E Ezzie, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

25112 Issued in TX

Practice address

4548 Bissonnet St
Suite 200
Bellaire, TX 77401-3102

Phone

(713) 779-9000

Fax

(713) 779-9001

NPI assigned

Feb 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1720052970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4548 BISSONNET ST",
            "address_2": "SUITE 200",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774013102",
            "telephone_number": "713-779-9000",
            "fax_number": "713-779-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4548 BISSONNET ST",
            "address_2": "SUITE 200",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774013102",
            "telephone_number": "713-779-9000",
            "fax_number": "713-779-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZZIE",
        "first_name": "ELIE",
        "middle_name": "E",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "AZ",
            "license": "D6670",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "25112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evergreen Psychiatry, PLLC
• Eye Care Solutions, LLC
• Eye Center of Texas LLP
• James S Ezelle, M.D.
• Princess Ezenwa, NP
• Victoria Gacad Faires, FNP-C
• Faithful Hands Services
• Nessette Falu, RPA-C
• Family Mental Health Center, Inc.
• Kenneth Chen Fan, M.D., M.B.A.

• Endodontics in Bellaire, TX
• Providers in Bellaire, TX by specialty
• Endodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; 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.