ERIC EDWARD ELLIS (NPI# 1093971749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1093971749 |
Entity Type | Individual |
Full Name | ERIC EDWARD ELLIS |
Credential | DMD |
Practice Address |
31307 N 137th Ave Peoria AZ 85383-7941 |
Practice Telephone | 5863229041 |
Mailing Telephone | 5863229041 |
Enumeration Date | 2008-08-01 |
Last Update Date | 2010-11-09 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 122300000X | Dentist | 2901019386 | MI | Dental Providers |
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
7708 | AZ | Dental Providers |
N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
2901019386 | MI | Dental Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154741692 | Eric Daniel Ellis | Specialist/Technologist | 414 Bryan St, Havertown, PA 19083-4311 | 2014-04-23 |
1215968409 | Eric Lee Ellis | Emergency Medicine | 77 Lincoln Blvd Ste 1, Lincoln, CA 95648-7422 | 2006-07-05 |
1396178216 | Eric D Ellis | Physical Therapist | 1031 S Roselle Rd, Schaumburg, IL 60193-3960 | 2013-08-14 |
1609021021 | Eric Ellis | Dentist | 4600 Fairmont Pkwy, Suite 204, Pasadena, TX 77504-3335 | 2008-11-26 |
1477528644 | Eric R Ellis | Specialist | 605 Glenwood Drive, Suite 200, Chattanooga, TN 37404-1130 | 2006-02-21 |
Street Address |
31307 N 137TH AVE |
City | PEORIA |
State | AZ |
Zip Code | 85383-7941 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831701218 | West Point Optical Group | Optometrist | 24775 N. Pleasant Pkwy, Peoria, AZ 85383 | 2020-08-18 |
1528694247 | Lake Pleasant Kids Dentists and Orthodontics, LLP | Dentist | 24775 North Lake Pleasant Parkway Suite 104, Peoria, AZ 85383 | 2020-03-13 |
1124502273 | Nicole Angelina Hennigan | Registered Nurse | 9710 W. Happy Valley Rd, Suite 100 (salon 16), Peoria, AZ 85383 | 2018-09-24 |
1962994012 | Reach for The Stars Pediatric Therapy Pllc | Physical Therapy Assistant | 8662 W Lariat Ln, Peoria, AZ 85383 | 2018-06-05 |
1013417617 | Elite Infusions LLC | Internal Medicine | 10252 W Villa Chula, Peoria, AZ 85383 | 2018-02-20 |
1427577238 | Serene Valley Care LLC | Assisted Living Facility | 29751 N 119th Lane, Peoria, AZ 85383 | 2017-09-12 |
1255857827 | Advanced Air Amulance LLC | Ambulance | 9463 West El Cortez Place, Peoria, AZ 85383 | 2017-08-16 |
1427578996 | Paul R Arthur | Physical Therapist | 9745 W. Happy Valley Rd, Peoria, AZ 85383 | 2017-06-26 |
1528597143 | Lucy Denton | Specialist/Technologist | 9234 West Andrea Drive, Peoria, AZ 85383 | 2017-06-07 |
1801263579 | John Leano | Pharmacist | 26898 N 87th Dr, Peoria, AZ 85383 | 2015-08-28 |
Find all providers in zip 85383 |
Taxonomy Code | 1223P0221X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Pediatric Dentistry |
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568957199 | Maureen Malingkas | Dentist | 8248 W Deer Valley Rd, Peoria, AZ 85382-2198 | 2018-06-26 |
1396186276 | Larry Tyler Jackson | Dentist | 14100 N 83rd Ave, Ste 280, Peoria, AZ 85381-5658 | 2013-07-08 |
1942541206 | Robert Dean Matthews | Dentist | 25225 N Lake Pleasant Pkwy Ste 1235, Peoria, AZ 85383-1390 | 2013-03-12 |
1609141464 | Kids First Dental Group | Dentist | 7314 N Willow Lake Ct Ste D, Peoria, IL 61614-8289 | 2012-03-13 |
1649558578 | Morghan Elizabeth Teeters | Dentist | 7505 W. Deer Valley Rd, Suite 110, Peoria, AZ 85382 | 2011-07-26 |
1558656223 | Fatima P. Pimentel | Dentist | 7505 W Deer Valley Rd Ste 110, Peoria, AZ 85382-2107 | 2011-06-10 |
1952472276 | Christa Yvette Spates | Dentist | 1320 W Northmoor Rd, Peoria, IL 61614-3470 | 2006-11-10 |
1912095126 | Gregory Whelan | Dentist | 9840 W Yearling Rd, #1240, Peoria, AZ 85383-1377 | 2006-10-11 |
1629616826 | Morghan E. Teeters Dmd, Pllc | Dentist | 7505 W Deer Valley Rd Ste 110, Peoria, AZ 85382-2107 | 2019-12-18 |
1962923359 | Robert D Matthews, Dmd, Pllc | Dentist | 25225 N Lake Pleasant Pkwy Ste 1235, Peoria, AZ 85383-1390 | 2017-07-06 |
Find all providers in PEORIA |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.