Jacqueline Denise Ellis, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN0011584 Issued in FL

Practice address

5535 NW 7TH Ave
Miami, FL 33127-1401

Phone

(305) 759-1145

Fax

(305) 759-1145

NPI assigned

Mar 19, 2007

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1740304542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 PRESIDENTIAL WAY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331796437",
            "telephone_number": "305-757-7763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 NW 7TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331271401",
            "telephone_number": "305-759-1145",
            "fax_number": "305-759-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JACQUELINE",
        "middle_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN0011584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karl Brunell Ellins, D.M.D.
• Abigail Elliott, PT, DPT
• Evelyn Kay Elliott, MS
• Keri Ann Elliott, CRNA
• Horace A Ellis, M.S.N., A. R. N. P.
• Kaela Summer Ellis
• Laurette M Ellis, MD
• Sean Michael Ellis, APRN
• Sean Perry Ellis, DO
• Elma and Associates Inc.

• All providers in Miami, FL
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.