ERIC EDWARD ELLIS DMD NPI 1093971749

NPI Information

NPI: 1093971749
Provider Name: ERIC EDWARD ELLIS, DMD
Classification: Dentist - 1223P0221X
Entity Type: Individual

Specialization: Pediatric Dentistry

Address:
31307 N 137TH AVE
PEORIA, AZ
ZIP 85383
Phone: (586) 322-9041
Get Directions

Eric Edward Ellis, DMD is a pediatric dentistry dentist in Peoria, AZ. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. Eric Edward Ellis, DMD NPI is 1093971749. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

31307 N 137TH AVE
PEORIA, AZ
ZIP 85383-941
Phone: (586) 322-9041

The enumeration date for this NPI number is 8/1/2008 and was last updated on 11/9/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122300000X	Dentist		2901019386	MICHIGAN	No
2	1223P0221X	Dentist	Pediatric Dentistry	2901019386	MICHIGAN	No
3	1223P0221X	Dentist	Pediatric Dentistry	7708	ARIZONA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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