Jessica Adams Ellis, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D8758 Issued in OR

Practice address

8220 SW Warm Springs St
Suite 1114
Tualatin, OR 97062-9338

Phone

(503) 692-0337

NPI assigned

Mar 26, 2007

Sex

Female

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

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Edward D. Lacy, DMD. Fagd, PC

  • General Practice Dentistry
  • Tualatin, OR
  • NPI 1043369598
  NPD (past)
• Warm Springs Dental, LLC

  • General Practice Dentistry
  • Tualatin, OR
  • NPI 1366830341
  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1851419451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8220 SW WARM SPRINGS ST",
            "address_2": "SUITE 200",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970629338",
            "telephone_number": "503-692-0337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8220 SW WARM SPRINGS ST",
            "address_2": "SUITE 1114",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970629338",
            "telephone_number": "503-692-0337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JESSICA",
        "middle_name": "ADAMS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D8758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward D. Lacy, DMD. Fagd, PC
• Courtney V Edwards, LMT
• Ellen Fineman Physical Therapy Inc
• Ellen Nona Hoyven, P.T. P.C. (in Touch Physical Therapy)
• Ellingsen Speech Therapy, LLC
• Ashley Ellsworth, OTD, OTR/L, CHES
• Embodied Connections Therapy LLC
• Emergency and Acute Care Medical Company - Northwest, Inc.
• Emeritus Corporation (Brookdale River Valley Tualatin)
• Empower Speech Therapy

• Dentist in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.