Richard T. Ellison, DDS, Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6592 Issued in IN

Legal business name

RICHARD T. ELLISON, DDS, INC

Practice address

1602 W Jackson St
Muncie, IN 47303-4962

Phone

(765) 289-0236

Fax

(765) 289-8569

NPI assigned

Jun 15, 2015

Last updated

Jun 15, 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

Sherri J Richardson

Title

Office Manager

Phone

(765) 289-0236

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.

• Dick Tracy Ellison, DDS

  • General Practice Dentistry
  • Muncie, IN
  • NPI 1073616470
  NPD (past)

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1740661834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 W JACKSON ST",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473034962",
            "telephone_number": "765-289-0236",
            "fax_number": "765-289-8569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 W JACKSON ST",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473034962",
            "telephone_number": "765-289-0236",
            "fax_number": "765-289-8569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD T. ELLISON, DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-15",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "SHERRI",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "765-289-0236"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "6592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Travis A Rice
• Richard Gregory Pyle D.D.S., P.C.
• Richard Gregory Pyle DDS PC
• Richard L. Roudebush VA Medical Center
• Richard R. Nowakowski, DDS, LLC
• Samantha Richards, LCSW
• Jeremy P Richardson, RBT
• Margaret Richardson, LCSW
• Logan M Richmond
• Clinton Edgar Ricker

• General Practice Dentistry in Muncie, IN
• Providers in Muncie, 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 Jun 15, 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.