Green Lake Family and Cosmetic Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

GREEN LAKE FAMILY AND COSMETIC DENTISTRY

Practice address

8018 Aurora Ave N
Seattle, WA 98103-4350

Phone

(206) 258-4207

NPI assigned

Mar 24, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Cherryl Sue Ellison, DDSNPI 1407414956

Title

Dentist Owner

Phone

(812) 272-4602

Specialties & licenses 1

Addresses

Other names 1

• Green Lake Cosmetic Dentistry Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cherryl Sue Ellison, DDS

  • General Practice Dentistry
  • Seymour, IN
  • NPI 1407414956
  NPD Authorized official

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742774400000",
    "number": "1992506141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8018 AURORA AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981034350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8018 AURORA AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981034350",
            "telephone_number": "206-258-4207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN LAKE FAMILY AND COSMETIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-24",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-23",
        "status": "A",
        "authorized_official_last_name": "ELLISON",
        "authorized_official_first_name": "CHERRYL",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "812-272-4602",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Green Lake Cosmetic Dentistry",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Ronald A Greeley, MA, LMHC
• Rula Green Gladden, MD
• Green Grass Physical Therapy, LLC
• Green Lake Chiropractic & Nutritional Healing LLC
• Green Lake Facial Surgery PLLC
• Green Lake Massage Health Center, LLC
• Green Point Acupuncture L.L.C.
• Robin A Green Whipple, MD
• Gianna I Green-Baskett
• Suzette Faith Green-Roberts, OT

• Dental Clinic/Center in Seattle, WA
• Providers in Seattle, WA by specialty
• Dental Clinic/Center in Washington

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

Verify at the official NPI Registry.