Ellis Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

27622 Issued in TX

Legal business name

ELLIS DENTAL LLC

Practice address

2725 Ellis Ave
Suite B
Fort Worth, TX 76164-7106

Phone

(817) 801-9500

Fax

(817) 801-9501

NPI assigned

Oct 24, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Hiren A Patel, DDS

Title

Owner

Phone

(817) 801-9500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477267200000",
    "number": "1831640044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 E PARK ROW DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760104744",
            "telephone_number": "817-801-9500",
            "fax_number": "817-801-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 ELLIS AVE",
            "address_2": "SUITE B",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761647106",
            "telephone_number": "817-801-9500",
            "fax_number": "817-801-9501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIS DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-24",
        "last_updated": "2016-10-24",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "HIREN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-801-9500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Elliott, LPC, LMFT
• Melissa S Elliott, LMSW, LCDC, CADC II
• Peter J Elliott, MD
• Seth Elliott, D.C.
• Shannon Murphy Elliott, M.S., CCC-SLP
• Ellis Tooth Fairy PLLC
• Chandra Ellis, RN
• Christine R Ellis, MD
• Deborah W Ellis, CRNA
• Debra Kay Ellis, LPC, LBSW,ACBSW

• General Practice Dentistry in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; 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.