ELLIS DENTAL LLC NPI 1558895490

NPI Information

NPI: 1558895490
Provider Name: ELLIS DENTAL LLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
10296 BIG BEND RD
SUITE 207
SAINT LOUIS, MO
ZIP 63122
Phone: (314) 965-1334
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ELLIS DENTAL LLC is a dental clinic center in Saint Louis, MO. ELLIS DENTAL LLC NPI is 1558895490. The provider is registered as an organization entity type.

The provider's business location address is:

10296 BIG BEND RD
SUITE 207
SAINT LOUIS, MO
ZIP 63122-498
Phone: (314) 965-1334

The provider's authorized official is Holly Christine Ellis .
The authorized official title is Owner and has the following contact phone number (314) 965-1334.

The enumeration date for this NPI number is 4/18/2017 and was last updated on 4/18/2017.

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	261QD0000X	Clinic/Center	Dental	2006021179	MISSOURI	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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