Randal Stuart Elloway, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DDS40581 Issued in CA

Practice address

2426 S Main St
Red Bluff, CA 96080-4337

Phone

(530) 527-6777

Fax

(530) 527-6551

NPI assigned

Feb 21, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Noura Elloway RDH Randal Elloway DDS Corp

  dba Dental Sleep Solutions Group

  • General Practice Dentistry
  • Red Bluff, CA
  • NPI 1790400679
  NPD
• Sleep Impressions, LLC

  dba Sleep Impressions

  • Specialist
  • Saint Louis, MO
  • NPI 1134547912

  Dentist

  NPD (past)

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1942345251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2426 S MAIN ST",
            "address_2": "RED BLUFF",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960804337",
            "telephone_number": "530-527-6777",
            "fax_number": "530-527-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2426 S MAIN ST",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960804337",
            "telephone_number": "530-527-6777",
            "fax_number": "530-527-6551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLOWAY",
        "first_name": "RANDAL",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40581",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS40581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Eischen, FNP
• Kate Ashley Ellis, PA-C
• Randy Wayne Ellis
• Angie Denise Elloway, DDS
• Natasha Elloway, DDS
• Emeritus Corporation (Brookdale Red Bluff)
• Brian S Emery, CATC
• Empower Tehama
• Karen Englent
• Eric&Jamesllc

• Dentist in Red Bluff, CA
• Providers in Red Bluff, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; 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.