Elise Kathryn Ellingsen Miller, DDS, MSD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DE61168159 Issued in WA

Practice address

1005 N Evergreen Rd Ste 201
Spokane Valley, WA 99216-1485

Phone

(509) 921-5666

NPI assigned

Apr 28, 2021

Last updated

Apr 28, 2021By the provider in NPPES

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

Other names 1

• Elise Kathryn Ellingsen Former name

Medicare fee-for-service enrollment

Enrolled in WA

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

Locations

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.

• Ellingsen and Denison Endodontics, PLLC

  • Endodontics
  • Spokane Valley, WA
  • NPI 1962169029
  NPD Authorized official
• Ellingsen Endodontics PLLC

  • Endodontics
  • Spokane Valley, WA
  • NPI 1447369350
  NPD (past)

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1962085951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4213 STONE WAY N APT 410",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981037474",
            "telephone_number": "509-389-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 N EVERGREEN RD STE 201",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161485",
            "telephone_number": "509-921-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLINGSEN MILLER",
        "first_name": "ELISE",
        "middle_name": "KATHRYN",
        "credential": "DDS, MSD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "DE61168159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELISE",
            "last_name": "ELLINGSEN",
            "middle_name": "KATHRYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeanne M Ellern, PAC
• Jamie Lee Ellertsen, CDP
• Ellingsen -Paxton DDS PS (Ellingsen Paxton Johnson Orthodontics)
• Ellingsen and Denison Endodontics, PLLC
• Ellingsen Endodontics PLLC
• Eric C Ellingsen, DDS
• Lisa Ann Ellingsen, DDS MS
• Michelle A Ellingsen, DDS,MSD
• Richard C Ellingsen
• Christopher Elliott

• Endodontics in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Endodontics in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.