ELLIS & WALTERS DENTAL CARE (NPI# 1538218664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538218664 |
| Entity Type | Organization |
| Organization Name | ELLIS & WALTERS DENTAL CARE |
| Practice Address |
1434 Parker Drive Laurel MS 39440 |
| Practice Telephone | 6016493335 |
| Practice Fax Number | 6014266318 |
| Mailing Telephone | 6016493335 |
| Mailing Fax Number | 6014266318 |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ROBERT STEPHEN ELLIS (DENTIST) |
| Authorized Official Telephone | 6016493335 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
171176 | MS | Dental Providers |
| Street Address |
1434 PARKER DRIVE |
| City | LAUREL |
| State | MS |
| Zip Code | 39440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932355534 | Fred Irvin Walters Jr. | Dentist | 1434 Parker Drive, Laurel, MS 39440-1942 | 2008-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306323159 | Tender Loving Care Homecare LLC | Homemaker | 509 Central Ave Ste 224, Laurel, MS 39440 | 2018-07-24 |
| 1669837910 | Laurel Dental Properties | Dentist | 1925 Pine Belt Drive, Laurel, MS 39440 | 2015-12-30 |
| 1215282991 | South Central Regional Medical Center | Clinic/Center | 525 Wayne Drive, Laurel, MS 39440 | 2012-07-18 |
| 1568721215 | Terry Ratcliff Perkins | Counselor | 5192 Hwy 11 North, Laurel, MS 39440 | 2012-05-15 |
| 1437453057 | Alexander Milne Home for Women | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 616 East 19th Street, Laurel, MS 39440 | 2010-12-23 |
| 1710135629 | Jeffrey R. Moffett | Nurse Practitioner | 3115 Audubon Dr, Laurel, MS 39440 | 2008-09-04 |
| 1003096785 | Family Health Center, Inc | Obstetrics & Gynecology | 103 S. 12th Avenue, Laurel, MS 39440 | 2007-11-09 |
| 1669672143 | Laurel Urology Clinic Pa | Urology | 304 S 10th Ave, Laurel, MS 39440 | 2007-07-23 |
| 1093912370 | Tanweer Hussain Majid | Surgery | 1007 Jefferson Street, Laurel, MS 39440 | 2007-06-29 |
| 1780889923 | Hattiesburg Eye Clinic, Pa | Ophthalmology | 1431 North 10th St, Suite 1, Laurel, MS 39440 | 2007-06-18 |
| Find all providers in zip 39440 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942769468 | Vaibhav Rai Dds LLC | Dentist | 7350 Van Dusen Rd Ste 440, Laurel, MD 20707-5265 | 2019-03-14 |
| 1487148631 | Munsha Sidhu Chadha | Dentist | 595 Main St Ste 237, Laurel, MD 20707 | 2018-06-20 |
| 1104319029 | Charming Smiles Family Dentistry | Dentist | 14333 Laurel Bowie Rd Ste 307, Laurel, MD 20708-1183 | 2018-06-14 |
| 1265959837 | Lifetime Dental Care of Maryland, Badger, P.C. | Dentist | 13919 Baltimore Ave, Laurel, MD 20707-5044 | 2017-08-24 |
| 1245602168 | Robert F. Gradishar Dds Pa | Dentist | 11200 Scaggsville Rd Ste 119, Laurel, MD 20723-2024 | 2015-10-30 |
| 1891167193 | Laurel Pines Dental 100 LLC | Dentist | 14333 Laurel Bowie Rd Ste 100, Laurel, MD 20708-1149 | 2015-10-26 |
| 1447695127 | Jeffrey Bartoshesky | Dentist | 10250 Stone Creek Dr Unit 1, Laurel, DE 19956-4707 | 2013-05-08 |
| 1508111907 | Halima R Karim | Dentist | 8383 Cherry Ln, Laurel, MD 20707-4832 | 2012-07-21 |
| 1154631075 | Dental Professionals of Maryland, Gerald Awadzi, PC | Dentist | 7500 Montpelier Rd Ste 108, Laurel, MD 20723-6012 | 2010-10-13 |
| 1750522181 | Sung Joo Kim | Dentist | 7302 Waterloo Walk, Laurel, MD 20707-6914 | 2009-03-15 |
| Find all providers in LAUREL | ||||
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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.