ROBERT KENNER ELLIS (NPI# 1568479228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568479228 |
| Entity Type | Individual |
| Full Name | ROBERT KENNER ELLIS |
| Credential | DDS |
| Practice Address |
17542 Irvine Blvd Suite B Tustin CA 92780 |
| Practice Telephone | 7148380575 |
| Practice Fax Number | 7148388497 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 45457 | CA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881945566 | Robert Ray Ellis | Military Health Care Provider | 10194 Cottage Ct, Diberville, MS 39540-4744 | 2012-09-21 |
| 1336392224 | Robert Ellis | Specialist/Technologist, Other | 8008 Blue Hole Ct, Mckinney, TX 75070-4896 | 2008-10-23 |
| 1124274394 | Robert Stephen Ellis | Dentist | 1434 - Parker Drive, Laurel, MS 39440-1942 | 2008-08-07 |
| 1083810709 | Robert Haig Ellis | Internal Medicine | 2412 Brookwood Drive, Fort Collins, CO 80525-1908 | 2007-06-21 |
| 1265534697 | Robert Frank Ellis | Obstetrics & Gynecology | 770 Elysian Way, Deerfield, IL 60015-4500 | 2006-09-05 |
| 1083724843 | Robert Lynn Ellis | Dentist | 143 1/2 E Main, Rigby, ID 83442 | 2006-08-30 |
| 1932111739 | Robert George Ellis | Radiology | 1204 E 29th St, Tulsa, OK 74114-3907 | 2006-08-12 |
| 1366461337 | Robert Earle Ellis | Counselor | 273 Front St, Weymouth, MA 02188-2202 | 2006-07-19 |
| 1124006549 | Robert William Ellis IIi | Psychiatry & Neurology | 204 W Grand River Ave, Suite 260, Howell, MI 48843-2299 | 2006-01-05 |
| 1689185936 | Robert Brian Ellis | Audiologist | 318 W El Norte Pkwy, Escondido, CA 92026-1925 | 2017-10-13 |
| Street Address |
17542 IRVINE BLVD SUITE B |
| City | TUSTIN |
| State | CA |
| Zip Code | 92780 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205852761 | Pishya Chamkasem | Dentist | 17542 Irvine Blvd, Suite D, Tustin, CA 92780-3155 | 2006-07-15 |
| 1649695537 | Rodney Ida | Dentist | 17542 Irvine Blvd, Suite # A, Tustin, CA 92780-3155 | 2014-02-28 |
| 1770787624 | Marcela A Throckmorton | Marriage & Family Therapist | 17542 Irvine Blvd, Suite F, Tustin, CA 92780-3155 | 2007-06-13 |
| 1881816080 | Melinda Heim | Marriage & Family Therapist | 17542 Irvine Blvd, Suite F, Tustin, CA 92780-3155 | 2007-05-03 |
| 1538288840 | James Patrick Toner | Dentist | 17542 Irvine Blvd, Suite C, Tustin, CA 92780-3155 | 2007-03-28 |
| 1629118708 | Steven R Chew | Dentist | 17542 Irvine Blvd, Ste E, Tustin, CA 92780-3155 | 2007-02-07 |
| 1689757346 | Susan Adele Walters | Marriage & Family Therapist | 17542 Irvine Blvd, Suite F, Tustin, CA 92780-3155 | 2006-10-24 |
| 1104833938 | Bruce Robert Fredenburg | Marriage & Family Therapist | 17542 Irvine Blvd, Suite F, Tustin, CA 92780-3155 | 2006-08-02 |
| 1144244278 | Jeff P Blanks | Marriage & Family Therapist | 17542 Irvine Blvd, Suite F, Tustin, CA 92780-3155 | 2006-07-26 |
| 1003839614 | Jason William Austin | Marriage & Family Therapist | 17542 Irvine Blvd, #f, Tustin, CA 92780-3155 | 2006-07-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437780947 | John Michael Michael | Pharmacist | 14481 Wildeve Ln, Tustin, CA 92780 | 2020-02-03 |
| 1609426881 | Abigail Joy Maqsood | Behavior Technician | 290a S Prospect Ave, Tustin, CA 92780 | 2019-09-19 |
| 1255814711 | Hyun Dong Lee | Chiropractor | 14591 Newport Ave Ste 106, Tustin, CA 92780 | 2018-09-11 |
| 1346733573 | Elizabeth Kim Nguyen Dds Inc | Clinic/Center | 14521 Red Hill Ave, Tustin, CA 92780 | 2018-06-12 |
| 1255829503 | Hw Physical Therapy | Physical Therapist | 250 El Camino Real Ste 100, Tustin, CA 92780 | 2018-04-23 |
| 1912494352 | Gary Wayne Mcbeath | Marriage & Family Therapist | 17821 E 17th Street, Suite # 260, Tustin, CA 92780 | 2018-04-20 |
| 1104334598 | Catherine Bogues | Speech-Language Pathologist | 661 West 1st Street, Suite E, Tustin, CA 92780 | 2018-01-19 |
| 1972019941 | Lighthouse Behavioral Solutions | Behavioral Analyst | 18002 Irvine Blvd., Suite 202c, Tustin, CA 92780 | 2017-12-28 |
| 1629597299 | Lifecab, LLC | Non-emergency Medical Transport (VAN) | 13732 Newport Ave, Suite #1, Tustin, CA 92780 | 2017-09-14 |
| 1437606555 | Tustin Speech Therapy, Inc. | Speech-Language Pathologist | 661 West First Street, Suite E, Tustin, CA 92780 | 2016-09-07 |
| Find all providers in zip 92780 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841846292 | Jerry K Wu Dmd Inc | Dentist | 1254 Irvine Blvd Ste 160, Tustin, CA 92780-3573 | 2019-08-12 |
| 1538722087 | Haque Dental Corporation | Dentist | 17662 Irvine Blvd Ste 2, Tustin, CA 92780-3132 | 2019-04-19 |
| 1457816340 | Rahimian Dental Corporation | Dentist | 13011 Newport Ave Ste 205, Tustin, CA 92780-3517 | 2019-02-05 |
| 1487175410 | Vanson Dental Corporation | Dentist | 15160 Kensington Park Drive, Ste 610, Tustin, CA 92782 | 2017-06-29 |
| 1417406323 | Barry Mitchell | Dentist | 2660 Cypress Pt, Tustin, CA 92782-1244 | 2016-10-04 |
| 1144672270 | Leiza Yamila Walia | Dentist | 15160 Kensington Park Dr Ste 610, Tustin, CA 92782 | 2016-07-13 |
| 1689040115 | Naman Desai | Dentist | 13132 Newport Ave Ste 230, Tustin, CA 92780-3429 | 2015-08-19 |
| 1679951289 | Wen Lin Liu | Dentist | 14771 Plaza Dr Ste D, Tustin, CA 92780-2779 | 2015-05-14 |
| 1063842029 | Raymond Y Choi | Dentist | 17502 W. Irvine Blvd, Suite B, Tustin, CA 92780 | 2013-11-12 |
| 1841631611 | Nadia Abazarnia | Dentist | 16608 Sonora St, Tustin, CA 92782-1938 | 2013-07-09 |
| Find all providers in TUSTIN | ||||
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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.