Chad W. Ellsworth, D.M.D.,M.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

S6-39 Issued in NV

Practice address

2843 St. Rose Pkwy
Suite 100
Henderson, NV 89052

Phone

(702) 531-5437

Fax

(702) 616-3565

NPI assigned

Sep 5, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

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

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ellsworth Cox Pediatric Dentistry LLC

  dba Anthem Pediatric Dentistry

  • Pediatric Dentistry
  • Henderson, NV
  • NPI 1417041146
  NPD (past)

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1841392172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 SWINGLINE DRIVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "89015",
            "telephone_number": "702-564-7869",
            "fax_number": "702-616-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2843 ST. ROSE PKWY",
            "address_2": "SUITE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "89052",
            "telephone_number": "702-531-5437",
            "fax_number": "702-616-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "CHAD",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.,M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NV",
            "license": "S6-39",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Ellis
• Ellsworth Cox NV Specialty Dental Services, PLLC
• Ellsworth Cox NV Specialty Dental Services, PLLC (Anthem Pediatric Dentistry)
• Ellsworth Cox Pediatric Dentistry LLC (Anthem Pediatric Dentistry)
• Ellsworth Dental LP
• Evan Bale Ellsworth, DMD
• Robert Dean Ellsworth
• Geraldine Elmore
• Joanie Luyn Elsten, RN
• Matthew Louis Eltgroth, MD

• Pediatric Dentistry in Henderson, NV
• Providers in Henderson, NV by specialty
• Pediatric Dentistry in Nevada

• 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.