Jeffrey Ellenberg DMD PA

Primary specialty

DentistTaxonomy code 122300000X

License

DN11742 Issued in FL

Legal business name

JEFFREY ELLENBERG DMD PA

Practice address

1430 Belcher Road South
Clearwater, FL 33764

Phone

(727) 531-7751

Fax

(727) 532-3006

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Ellenberg, DMDNPI 1114026572

Title

President Dentist Owner

Phone

(727) 531-7751

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.

• Jeffrey Ellenberg, DMD

  • Dentist
  • Clearwater, FL
  • NPI 1114026572
  NPD (past) Authorized official

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740389030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 BELCHER ROAD SOUTH",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "33764",
            "telephone_number": "727-531-7751",
            "fax_number": "727-532-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 BELCHER ROAD SOUTH",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "33764",
            "telephone_number": "727-531-7751",
            "fax_number": "727-532-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY ELLENBERG DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLENBERG",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT DENTIST OWNER",
        "authorized_official_telephone_number": "727-531-7751",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN11742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• JCS Medical Associates PLC
• JDG Circle Inpatient Services LLC
• Nisrene Jebara, DNP
• Orinthal Jefferson, MASTERS
• Rashad M Jefferson, D.D.S.
• Jeffrey M Karp MD PA
• Eve M. Jehle, M. D.
• Aja N Jenkins
• Julia Jenkins, MD
• Savannah Jenkins, RBT

• Dentist in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.