Active NPI
Latavias Demetrius Ellington, DDS
- Pediatric Dentistry
- Bethesda, MD
National Provider Identifier
1982734075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 13834
- Practice address
- 7425 Arlington Rd
Bethesda, MD 20814-5321 - Phone
- (301) 654-8024
- NPI assigned
- Mar 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 13834 | MD | |
| Dentist | 122300000X | DEN1000572 | DC | |
| Pediatric Dentistry | 1223P0221X | 13834 | MD | Primary |
Addresses
Primary practice location
7425 Arlington Rd
Bethesda, MD 20814-5321
Mailing address
4835 Cordell Ave
#524
Bethesda, MD 20814-3147
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 522116489 | Other | MD | TAX IDENTIFICATION NUMBER |
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 |
|---|---|---|---|
| DEN1000572 | DC | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Chair Dentistry for Pediatrics and Adolescents | Current | Accepting new patients |
Interoperability endpoints
- lellington1240553@direct.umm.edu
Organizations & group practices 1
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.
-
- Dental Clinic/Center
- Burtonsville, MD
- NPI 1114597994
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638316800000",
"number": "1982734075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4835 CORDELL AVE",
"address_2": "#524",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208143147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7425 ARLINGTON RD",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208145321",
"telephone_number": "301-654-8024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLINGTON",
"first_name": "LATAVIAS",
"middle_name": "DEMETRIUS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-07",
"last_updated": "2021-12-01",
"certification_date": "2021-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "13834",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "DC",
"license": "DEN1000572",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MD",
"license": "13834",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX IDENTIFICATION NUMBER",
"identifier": "522116489",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bethesda, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.