Active NPI
Jacqueline Ellis, DDS
- Dentist
- Paris, TN
National Provider Identifier
1982594784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12907
- Practice address
- 715 Morton St
Paris, TN 38242-4296 - Phone
- (731) 363-8803
- NPI assigned
- Jul 3, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12907 | TN | Primary |
Addresses
Primary practice location
715 Morton St
Paris, TN 38242-4296
Mailing address
210 Peaceful Meadows LN
Paris, TN 38242-7552
Phone (731) 363-8803
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12907 | TN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1751500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751500800000",
"number": "1982594784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 PEACEFUL MEADOWS LN",
"city": "PARIS",
"state": "TN",
"postal_code": "382427552",
"telephone_number": "731-363-8803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 MORTON ST",
"city": "PARIS",
"state": "TN",
"postal_code": "382424296",
"telephone_number": "731-363-8803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "JACQUELINE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-07-03",
"last_updated": "2025-07-03",
"certification_date": "2025-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TN",
"license": "12907",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paris, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.