ELLIS BURKE JARDINE, DMD, PC (NPI# 1720458359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720458359 |
| Entity Type | Organization |
| Organization Name | ELLIS BURKE JARDINE, DMD, PC |
| Other Organization Name | ADVANCED DENTAL SPECIALISTS |
| Practice Address |
406 Se 131st Ave Ste 305 Vancouver WA 98683-4014 |
| Practice Telephone | 3602539792 |
| Practice Fax Number | 3606045266 |
| Mailing Telephone | 3602539792 |
| Mailing Fax Number | 3606045266 |
| Enumeration Date | 2015-09-24 |
| Last Update Date | 2015-09-24 |
| Authorized Official Name | DR. ELLIS BURKE JARDINE (OWNER) |
| Authorized Official Telephone | 3602539792 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
60339865 | WA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA | FJ4151318 | 01 | |
| WA | WA DENTAL LICENSE | WA 60339865 | 01 |
| Other Name | Type Code |
|---|---|
| Advanced Dental Specialists | Doing Business As Name - Organization |
| Street Address |
406 SE 131ST AVE STE 305 |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98683-4014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235761222 | Nathaniel James Eugene Powell | Behavior Technician | 4101se 192nd Ave, Ste 101, Vancouver, WA 98683 | 2020-02-07 |
| 1295294973 | Ubmhc1, LLC | Clinical Medical Laboratory | 18110 Southeast 34th St, Building 2, Suite 240, Vancouver, WA 98683 | 2019-03-13 |
| 1982116695 | Amy K Adams | Massage Therapist | 2716 Se 169th Ave, X-232, Vancouver, WA 98683 | 2017-11-03 |
| 1477088920 | Alexandra Ransonet | Dental Hygienist | 19111 Se 34th. St., Vancouver, WA 98683 | 2017-04-21 |
| 1639618630 | Digestive Gi Care | Internal Medicine | 305 Sw Chkalov Dr, 111-140, Vancouver, WA 98683 | 2017-02-23 |
| 1447706742 | Jennifer Horst | Massage Therapist | 3401 Se 192nd. Ave. Suite 107, Vancouver, WA 98683 | 2016-08-28 |
| 1154702728 | Kacie Marie Hamreus | Physician Assistant | 3101 Se 192nd Avenue, Vancouver, WA 98683 | 2015-06-09 |
| 1851782338 | Kathryn Wiedeman | Physical Therapy Assistant | 801 Se Park Crestt Ave, Vancouver, WA 98683 | 2015-02-05 |
| 1407255326 | Jesse Ryan Moses | Dentist | 16600 Se 15th Street, Suite A, Vancouver, WA 98683 | 2014-08-15 |
| 1366869893 | Stephen J Wold II | Podiatrist | 16701 Ne Mcgillivray Blvd, Ste 220, Vancouver, WA 98683 | 2014-03-21 |
| Find all providers in zip 98683 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821102229 | Charles R Dufort | Dentist | 1300 Esther St, Suite 101, Vancouver, WA 98660-2889 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275184459 | Pi-yu Hsu | Dentist | 509 Olive Way Ste 1043, Seattle, WA 98101-1724 | 2019-09-27 |
| 1295383925 | K Miller Dds Ms Pllc | Dentist | 9800 Ne 120th Pl Ste C, Kirkland, WA 98034-4220 | 2019-08-27 |
| 1205394681 | Dana Buglione | Dentist | 1959 Ne Pacific St Hsb Room B-469, Seattle, WA 98195-0001 | 2019-03-05 |
| 1548779515 | Northwest Center for Prosthodontics | Dentist | 3425 Ensign Rd Ne Ste 210, Olympia, WA 98506-5063 | 2017-09-22 |
| 1275089872 | Timothy J. Butson Dmd, Msd, Pllc | Dentist | 600 University St Ste 819, Seattle, WA 98101-4117 | 2016-09-01 |
| 1659724102 | Will Eunku Chung II Dds Msd Pllc | Dentist | 509 Olive Way Ste 1416, Seattle, WA 98101-1749 | 2016-07-20 |
| 1609229699 | Albert Chung Dental Clinic | Dentist | 12715 Bel Red Rd Ste 201, Bellevue, WA 98005-2627 | 2016-07-14 |
| 1831558907 | Ellis Jardine, Dmd, Pllc | Dentist | 1401 Nw 1st St Ste 120, Battle Ground, WA 98604-4540 | 2016-02-18 |
| 1144694787 | Brooksjohnsonpllc | Dentist | 1004 S. Monroe Street, Ste 100, Spokane, WA 99204 | 2015-11-19 |
| 1649642638 | Northwest Implants and Sleep Dentistry | Dentist | 9911 N. Nevada Ave, Suite 120, Spokane, WA 99218-2500 | 2015-10-29 |
| Find all providers with the same taxonomy | ||||
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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.