DR. WAYNE R. ELLIS (NPI# 1427166024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427166024 |
| Entity Type | Individual |
| Full Name | DR. WAYNE R. ELLIS |
| Credential | D.D.S. |
| Practice Address |
6363 W Emerald St Building 102 Boise ID 83704-8783 |
| Practice Telephone | 2083766307 |
| Practice Fax Number | 2083769011 |
| Mailing Telephone | 2083766307 |
| Mailing Fax Number | 2083769011 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
D-1522 | ID | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538219704 | Wayne Enoch Ellis | Nurse Anesthetist, Certified Registered | 1038 N Eisenhower Dr, Suite 152, Beckley, WV 25801-3116 | 2007-01-11 |
| 1508848102 | Wayne M. Ellis | Internal Medicine | 550 University Blvd, Uh 3005, Indianapolis, IN 46202-5149 | 2005-11-18 |
| Street Address |
6363 W EMERALD ST BUILDING 102 |
| City | BOISE |
| State | ID |
| Zip Code | 83704-8783 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790892610 | Bruce Morrison | Dentist | 6363 W Emerald St, Suite 103, Boise, ID 83704-8783 | 2006-08-24 |
| 1619133923 | Scott Freeman, D.m.d., P.a. | Clinic/Center | 6363 W Emerald St, #101, Boise, ID 83704-8783 | 2008-08-06 |
| 1699949750 | Boise Oral and Maxillofacial Surgery | Dentist | 6363 W Emerald St, Suite 103, Boise, ID 83704-8783 | 2008-04-18 |
| 1265540835 | Bruce E Newcomb | Dentist | 6363 W Emerald St, #102, Boise, ID 83704-8783 | 2006-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535893 | Laura Diggs | Counselor | 400 North Benjamin Lane, Suite 200, Boise, ID 83704 | 2020-10-15 |
| 1891304002 | Tree City Family Dental | Dentist | 7301 W. Emerald St Ste. 102, Boise, ID 83704 | 2020-07-24 |
| 1982230710 | Jessica Wynn Councell | Midwife | 1072 N Liberty St Ste 100, Boise, ID 83704 | 2020-03-12 |
| 1699307124 | Isabel Burns Bruce | Registered Nurse | 777 N Raymond Street, Boise, ID 83704 | 2020-02-12 |
| 1558903328 | Daring In Idaho, LLC | Social Worker | 413 N Allumbaugh Street, Suite 102, Boise, ID 83704 | 2019-10-14 |
| 1053960286 | Kyle Hiromi Hatanaka | Acupuncturist | 9450 #120 Fairview Avenue, Boise, ID 83704 | 2019-09-10 |
| 1700447141 | Katie Elizabeth Nichols | Physician Assistant | 1072 N Liberty St Ste 201, Boise, ID 83704 | 2019-06-26 |
| 1588164727 | Cory Michael Sims | Counselor | 6550 W. Emerald St #112, Boise, ID 83704 | 2018-02-14 |
| 1477072270 | Matthew Lee Love | Non-emergency Medical Transport (VAN) | 6933 W. Stratton St, Boise, ID 83704 | 2017-09-12 |
| 1942735949 | Dalana Sue Thompson | Counselor | 9196 Emerald St Suite #130, Boise, ID 83704 | 2017-04-27 |
| Find all providers in zip 83704 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437455961 | Herbert Ray Blaser | Dentist | 2104 N. Cole Rd., Boise, ID 83704 | 2011-02-01 |
| 1396961157 | Larue Antoine Bluth | Dentist | 5244 N Eagle Rd, Boise, ID 83713-0945 | 2007-04-18 |
| 1417096678 | Idaho Endodontics Pa | Dentist | 2014 N Cole Rd, Boise, ID 83704 | 2007-02-05 |
| 1932259173 | Brent L Chapman | Dentist | 1555 S Timesquare Ln, Boise, ID 83709-8266 | 2007-01-11 |
| 1811077589 | Hilary I Dunstan | Dentist | 6363 W Emerald St Ste 102, Boise, ID 83704-8783 | 2006-10-17 |
| 1124139134 | Michael John Bingham | Dentist | 3308 N Milwaukee St, Boise, ID 83704-4447 | 2006-08-31 |
| 1710509823 | Idaho Endodontics | Dentist | 1555 S Timesquare Ln, Boise, ID 83709-8266 | 2020-05-12 |
| 1407483027 | Northwest Dental Group | Dentist | 8300 Northview St, Boise, ID 83704 | 2020-03-24 |
| 1881861581 | Robert Olson Jr. | Dentist | 8119 Ustick Rd, Boise, ID 83704-5754 | 2008-05-12 |
| 1114077369 | Adam J Shipp | Dentist | 1555 S Timesquare Ln, Boise, ID 83709-8266 | 2007-01-11 |
| Find all providers in BOISE | ||||
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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.