DAVID ALAN ELLSWORTH DDS NPI 1184804221

NPI Information

  • NPI: 1184804221
  • Provider Name: DAVID ALAN ELLSWORTH, DDS
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 523 W JEFFERSON ST
    PETOSKEY, MI
    ZIP 49770
  • Phone: (231) 347-8899

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NPI Details

David Alan Ellsworth, DDS is a general practice dentist in Petoskey, MI. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. David Alan Ellsworth, DDS NPI is 1184804221. 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:

523 W JEFFERSON ST
PETOSKEY, MI
ZIP 49770-271
Phone: (231) 347-8899

The NPI 1184804221 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/6/2007 and was last updated on 11/6/2007.

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
11223G0001XDentistGeneral Practice18740MICHIGANYes

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: 3/30/2025

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