Jerry R Ellis DDS PC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

JERRY R ELLIS DDS PC

Practice address

404 W Main St
Midlothian, TX 76065-2946

Phone

(972) 775-2345

NPI assigned

Mar 6, 2023

Last updated

Apr 20, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jerry R Ellis, DDS

Title

Owner/Dentist

Phone

(972) 775-2345

Specialties & licenses 2

Addresses

Other names 1

• Jerry R Ellis DDS PC Other name

Locations

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681948800000",
    "number": "1982304267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 W MAIN ST",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760652946",
            "telephone_number": "972-775-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 W MAIN ST",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760652946",
            "telephone_number": "972-775-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY R ELLIS DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "972-775-2345",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jerry R Ellis DDS PC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Jerry R Ellis DDS PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jennifer Ann Jackson, COTA
• Noe Luis Jaramillo, DDS
• Brittany Denae Jenkins
• Morgan Baily Jenkins, DPT
• Sammy Ray Jenkins, LPC-A
• Elissa Michelle Jeter, LPC
• JJJ Counseling & Associates, PLLC
• JM & MJ, LLC (Texas House Call Medical)
• Joche Healthcare
• John Buie DDS PLLC

• Customized Equipment (DME) in Midlothian, TX
• Providers in Midlothian, TX by specialty
• Customized Equipment (DME) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; 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.