David L. Ellis, DDS, LTD

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

5245 Issued in VA

Legal business name

DAVID L. ELLIS, DDS, LTD

Doing business as

Ellis Family Dentistry

Practice address

3416 Woodlawn St
Hopewell, VA 23860-4738

Phone

(804) 458-6733

NPI assigned

Nov 19, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Julia C Ellis

Title

Office Manager

Phone

(804) 458-6733

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Ellis Family Dentistry Doing business as

Tax ID family

David L Ellis DDS LTD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ellis Family Dentistry

  • General Practice Dentistry
  • Hopewell, VA
  • NPI 1023550233
  NPD tax ID

Locations

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195430400000",
    "number": "1841471737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3416 WOODLAWN ST",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238604738",
            "telephone_number": "804-458-6733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3416 WOODLAWN ST",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238604738",
            "telephone_number": "804-458-6733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID L. ELLIS, DDS, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-19",
        "last_updated": "2007-11-19",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "804-458-6733",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "VA",
            "license": "5245",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "VA",
            "license": "11395",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9179650",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9182633",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellis Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Creekside Post Acute LLC
• Jaclyn Amelia Crowley, FNP
• Emily Crutcher
• Daniel M. Baker, D.D.S PLLC
• Kamlesh Nandlal Dave, M.D.,F.A.C.C.
• Janet Reid Dawson, LPC
• Mary Kristine Sungahid Dela Cruz, PT
• Kristin Denise Dibler, MSW
• Brooke Glasscock Dimaio, M.S. OTR/L
• District 19 Community Service Board

• Dental Clinic/Center in Hopewell, VA
• Providers in Hopewell, VA by specialty
• Dental Clinic/Center in Virginia

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