DR. LYNAE D ELLIS (NPI# 1720161789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720161789 |
| Entity Type | Individual |
| Full Name | DR. LYNAE D ELLIS |
| Credential | D.D.S., M.S. |
| Practice Address |
1616 N Randall Ave Janesville WI 53545-1118 |
| Practice Telephone | 6087544998 |
| Practice Fax Number | 6087545652 |
| Mailing Telephone | 6087544998 |
| Mailing Fax Number | 6087545652 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
5282015 | WI | Dental Providers |
| Street Address |
1616 N RANDALL AVE |
| City | JANESVILLE |
| State | WI |
| Zip Code | 53545-1118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669024667 | Smile Doctors of Wisconsin, S.c. | Dentist | 1616 N Randall Ave, Janesville, WI 53545-1118 | 2019-07-10 |
| 1326163957 | Brian Mitchell Pelsue | Dentist | 1616 N Randall Ave, Janesville, WI 53545-1118 | 2007-03-20 |
| 1356424303 | Mitchell W Pelsue | Dentist | 1616 N Randall Ave, Janesville, WI 53545-1118 | 2006-10-23 |
| 1295818177 | Pelsue Orthodontics | Dentist | 1616 N Randall Ave, Janesville, WI 53545-1118 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730743816 | Wisteria Lyn Gunnink | Social Worker | 3530 N County Highway F, Janesville, WI 53545 | 2019-04-24 |
| 1730601295 | Selma Mohammedi | Dentist | 1260 Milton Ave Ste 140-150, Janesville, WI 53545 | 2017-07-16 |
| 1205357472 | Andrea Jayne Thompson | Physical Therapist | 3418 N Parker Dr., Janesville, WI 53545 | 2017-06-28 |
| 1639549983 | Sylvia Andrus | Physical Therapy Assistant | 3400 N Country Highway F, Janesville, WI 53545 | 2015-09-30 |
| 1518372564 | Kimberly Ann Bishop | Registered Nurse | 32 E. Racine Street, Suite 150, Janesville, WI 53545 | 2014-06-29 |
| 1679998314 | Quirt Family Dentistry | Dentist | 2201 Humes Road Suite 150, Janesville, WI 53545 | 2014-03-04 |
| 1104163740 | Sarah J Fredricks | Licensed Practical Nurse | 1406 Holiday Drive, Janesville, WI 53545 | 2013-01-15 |
| 1659629335 | Parvin Mesbah | Pharmacist | 2017 Old Humes Road, T-0809, Janesville, WI 53545 | 2012-08-28 |
| 1962797118 | Tiffany Schmidt | Pharmacist | 2017 Humes Road, T-0809, Janesv Ille, WI 53545 | 2011-06-16 |
| 1174817795 | Megan Steiner | Dentist | 1504 Creston Park Drive, Janesville, WI 53545 | 2011-05-31 |
| Find all providers in zip 53545 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831340827 | Paul Nicholas Romanelli | Dentist | 1504 N. Randall Ave., Janesville, WI 53545-1117 | 2008-10-08 |
| 1669024667 | Smile Doctors of Wisconsin, S.c. | Dentist | 1616 N Randall Ave, Janesville, WI 53545-1118 | 2019-07-10 |
| 1326163957 | Brian Mitchell Pelsue | Dentist | 1616 N Randall Ave, Janesville, WI 53545-1118 | 2007-03-20 |
| 1376673533 | Wisconsin Dental Group, S.c. | Dentist | 1407 N Wright Rd, Janesville, WI 53546-1314 | 2007-03-06 |
| 1821138454 | David Griffin | Dentist | 1407 N Wright Rd, Janesville, WI 53546-1314 | 2007-02-06 |
| 1356424303 | Mitchell W Pelsue | Dentist | 1616 N Randall Ave, Janesville, WI 53545-1118 | 2006-10-23 |
| 1295818177 | Pelsue Orthodontics | Dentist | 1616 N Randall Ave, Janesville, WI 53545-1118 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407488075 | Kristo Ltd | Dentist | 440 Chestnut St # 100, Wisconsin Rapids, WI 54494-4807 | 2020-02-11 |
| 1578104006 | Daniela Amaya Fuenmayor | Dentist | 11011 W North Ave Apt 367, Wauwatosa, WI 53226-2271 | 2019-10-07 |
| 1295382992 | Noble Orthodontics, LLC | Dentist | 109 N Dodge St, Burlington, WI 53105-1918 | 2019-08-19 |
| 1295391472 | Christine Lowdon Triggs | Dentist | 21680 West Bluemound Rd, Waukesha, WI 53186 | 2019-05-14 |
| 1811498561 | Orthodontic Specialists of Onalaska and The Coulee Region | Dentist | 2747 National Dr, Onalaska, WI 54650-8784 | 2018-02-27 |
| 1508247198 | Lauren Evan Montoure Teske | Dentist | 2000 Shady Ln, Green Bay, WI 54313-9311 | 2015-06-09 |
| 1588042154 | Bubon & Associates, Orthodontics, Sc | Dentist | 4950 S 27th St, Milwaukee, WI 53221-2606 | 2015-05-14 |
| 1235517897 | 1bubon & Associates, Orthodontics, Sc | Dentist | 1701 N Mayfair Rd, Suite C, Wauwatosa, WI 53226-3046 | 2015-05-14 |
| 1851779417 | Bubon & Associates, Orthodontics, Sc | Dentist | W188s7830 Racine Ave, Suite 300, Muskego, WI 53150-8290 | 2015-05-14 |
| 1578941548 | Bubon & Associates, Orthodontics, Sc | Dentist | N4w21680 Bluemound Rd, Waukesha, WI 53186-2943 | 2015-05-11 |
| Find all providers with the same taxonomy | ||||
| City | JANESVILLE |
| Zip Code | 53545 |
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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.