SPENCER A. ELLIS NPI 1194900464

NPI Information

NPI: 1194900464
Provider Name: SPENCER A. ELLIS
Classification: Dentist - 1223G0001X
Specialization: General Practice
Entity Type: Organization
Doing Business As: ELLIS FAMILY DENTISTRY
Address: 170 SCOTT HIGH DR
HUNTSVILLE, TN
ZIP 37756
Phone: (423) 663-4444

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NPI Details

SPENCER A. ELLIS is a general practice dentist in Huntsville, TN. 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. SPENCER A. ELLIS NPI is 1194900464. The provider is registered as an organization entity type.
The provider Is Doing Business As Ellis Family Dentistry.

The provider's business location address is:

170 SCOTT HIGH DR
HUNTSVILLE, TN
ZIP 37756-152
Phone: (423) 663-4444
Fax: (423) 663-4439

The provider's authorized official is Spencer A. Ellis .
The authorized official title is Owner and has the following contact phone number (423) 663-4444.

The enumeration date for this NPI number is 1/7/2008 and was last updated on 10/2/2023.

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	332BC3200X	Durable Medical Equipment & Medical Supplies	Customized Equipment			No
2	1223G0001X	Dentist	General Practice	DS7646	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3139906	OTHER	TENNESSEE	BLUE CROSS BLUE SHEILD

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: 11/21/2025

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