William S Dente Ellis, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1267 Issued in NE

Practice address

1940 Carswell Ave BLDG 7002
Lackland AFB, TX 78236-5514

Phone

(210) 916-9900

NPI assigned

Jun 10, 2013

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

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1952749152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 CARSWELL AVE BLDG 7002",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782365514",
            "telephone_number": "210-916-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 CARSWELL AVE BLDG 7002",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782365514",
            "telephone_number": "210-916-9900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12840 W Interstate 10 Ste 101",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782492361",
            "country_code": "US",
            "telephone_number": "936-689-0475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENTE ELLIS",
        "first_name": "WILLIAM",
        "middle_name": "S",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-10",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "V1439",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "1267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Carl Darius, CRNA
• Alejandro Davila, C.R.N.A.
• Logan Jay Davis, PT, DPT
• Judith Delmar, MD
• Jamie Lynn Deluca-King, AUD
• Alex A Deperalta Jr., D.D.S.
• Robert M. Dewitt, M.D.
• Evan M Dilley
• Dennis Carl Dixon, DDS
• George Michael Dockendorf, DO

• Family Medicine Physician in Lackland AFB, TX
• Providers in Lackland AFB, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.