DR. SAMUEL DWAYNE ELLSWORTH D.D.S. NPI 1891097168

NPI Information

  • NPI: 1891097168
  • Provider Name: DR. SAMUEL DWAYNE ELLSWORTH, D.D.S.
  • Classification: Dentist - 1223P0300X
  • Specialization: Periodontics
  • Entity Type: Individual
  • Address: 6333 E MOCKINGBIRD LN
    SUITE 254
    DALLAS, TX
    ZIP 75214
  • Phone: (214) 827-9500

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NPI Details

DR. Samuel Dwayne Ellsworth, D.D.S. is a periodontics dentist in Dallas, TX. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. DR. Samuel Dwayne Ellsworth, D.D.S. NPI is 1891097168. 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:

6333 E MOCKINGBIRD LN
SUITE 254
DALLAS, TX
ZIP 75214-692
Phone: (214) 827-9500
Fax: (214) 827-9502

The enumeration date for this NPI number is 11/18/2010 and was last updated on 2/18/2014.

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
1122300000XDentist25488TEXASNo
21223P0300XDentistPeriodontics25488TEXASYes

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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