Richard C Ellingsen

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DE00006352 Issued in WA

Practice address

12109 E Broadway Ave Ste B
Spokane Valley, WA 99206-6133

Phone

(509) 926-0570

Fax

(509) 921-9163

NPI assigned

Nov 19, 2009

Sex

Male

Sole proprietor

No

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ellingsen -Paxton DDS PS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Spokane Valley, WA
  • NPI 1558446278
  NPD (past) Authorized official
• Jason R. Scott DDS, PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Spokane Valley, WA
  • NPI 1417891524
  NPD (past)

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

{
    "created_epoch": "1258588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258588800000",
    "number": "1790013332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12109 E BROADWAY AVE STE B",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992066133",
            "telephone_number": "509-926-0570",
            "fax_number": "509-921-9163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12109 E BROADWAY AVE STE B",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992066133",
            "telephone_number": "509-926-0570",
            "fax_number": "509-921-9163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLINGSEN",
        "first_name": "RICHARD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-19",
        "last_updated": "2009-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "DE00006352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellingsen Endodontics PLLC
• Elise Kathryn Ellingsen Miller, DDS, MSD
• Eric C Ellingsen, DDS
• Lisa Ann Ellingsen, DDS MS
• Michelle A Ellingsen, DDS,MSD
• Christopher Elliott
• Felicia Irene Ellis
• Michelle Ellis
• Rachel Grace Ellis, PHARM D
• Craig C. Ellsworth, DDS

• Orthodontics and Dentofacial Orthopedics Dentistry in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; 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.