DR. GARY LYNN ELLIS DDS NPI 1700840717

NPI Information

  • NPI: 1700840717
  • Provider Name: DR. GARY LYNN ELLIS, DDS
  • Classification: Dentist - 1223P0106X
  • Specialization: Oral and Maxillofacial Pathology
  • Entity Type: Individual
  • Address: 500 CHIPETA WAY
    SALT LAKE CITY, UT
    ZIP 84108
  • Phone: (801) 583-2787

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NPI Details

DR. Gary Lynn Ellis, DDS is an oral and maxillofacial pathology dentist in Salt Lake City, UT. The provider is the specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. DR. Gary Lynn Ellis, DDS NPI is 1700840717. 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:

500 CHIPETA WAY
SALT LAKE CITY, UT
ZIP 84108-221
Phone: (801) 583-2787
Fax: (801) 584-5255

The enumeration date for this NPI number is 4/14/2006 and was last updated on 7/8/2007.

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
11223P0106XDentistOral and Maxillofacial Pathology5129775-9921UTAHYes

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
15129775-9921OTHERUTAHDENTAL LICENSE

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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