DR. SAMUEL DWAYNE ELLSWORTH (NPI# 1891097168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891097168 |
| Entity Type | Individual |
| Full Name | DR. SAMUEL DWAYNE ELLSWORTH |
| Credential | D.D.S. |
| Practice Address |
6333 E Mockingbird Ln Suite 254 Dallas TX 75214-2692 |
| Practice Telephone | 2148279500 |
| Practice Fax Number | 2148279502 |
| Mailing Telephone | 2148279500 |
| Mailing Fax Number | 2148279502 |
| Enumeration Date | 2010-11-18 |
| Last Update Date | 2014-02-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 25488 | TX | Dental Providers |
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
25488 | TX | Dental Providers |
| Street Address |
6333 E MOCKINGBIRD LN SUITE 254 |
| City | DALLAS |
| State | TX |
| Zip Code | 75214-2692 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730184482 | Joanne Gay Hoppe | Dentist | 6333 E Mockingbird Ln, Ste 255, Dallas, TX 75214-2367 | 2005-06-18 |
| 1730725417 | Ashley Nguyen | Pharmacist | 6333 E Mockingbird Ln, Dallas, TX 75214-2692 | 2019-11-18 |
| 1043640584 | Jonathan Kirsch | Physical Therapist | 6333 E Mockingbird Ln, Ste 139, Dallas, TX 75214-2692 | 2013-11-20 |
| 1780999383 | Alvin Willman | Pharmacist | 6333 E Mockingbird Ln, Dallas, TX 75214-2692 | 2010-08-09 |
| 1508178922 | Deborah Owen | Pharmacist | 6333 E Mockingbird Ln, Dallas, TX 75214-2692 | 2010-07-14 |
| 1780996108 | Diana Liu | Pharmacist | 6333 E Mockingbird Ln, Dallas, TX 75214-2692 | 2010-07-14 |
| 1003127838 | Michelle Dobbs | Family Medicine | 6333 E Mockingbird Ln, Suite 126, Dallas, TX 75214-2692 | 2010-06-26 |
| 1063739571 | Raymond Chiropractic Pa | Chiropractor | 6333 E Mockingbird Ln, Suite 260, Dallas, TX 75214-2692 | 2010-04-23 |
| 1164745337 | Murray Raymond | Chiropractor | 6333 E Mockingbird Ln, Suite 260, Dallas, TX 75214-2692 | 2010-03-02 |
| 1265762447 | C3 Chiropractic Pa | Chiropractor | 6333 E Mockingbird Ln, Sutie 223, Dallas, TX 75214-2692 | 2010-01-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316564990 | Ikids Pediatric Dentistry Lakewood, Pllc | Dentist | 2011 Abrams Parkway, Dallas, TX 75214 | 2020-06-30 |
| 1447714183 | Lcl Mental Health Services | Marriage & Family Therapist | 6060 North Central Expwy, Suite 500, Dallas, TX 75214 | 2019-01-28 |
| 1487136776 | Muriel Kim Jimenez | Occupational Therapist | 6301 Gaston Ave # 162p, Dallas, TX 75214 | 2018-09-03 |
| 1447783352 | Nietta Reynolds | Counselor | 4935 Junius, 9, Dallas, TX 75214 | 2017-04-07 |
| 1124551536 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 6474 E. Northwest Hwy, Dallas, TX 75214 | 2017-04-04 |
| 1093265324 | Sarah Gammon | Behavior Technician | 6908 Wake Forrest Dr, Dallas, TX 75214 | 2016-10-11 |
| 1669921466 | Ivan Barboza | Physical Therapy Assistant | 5931 Reiger Ave, Dallas, TX 75214 | 2016-09-22 |
| 1164892857 | Edwin Gulledge Grafton Jr. | Ophthalmology | 6235 Ravendale Ln., Dallas, TX 75214 | 2015-10-07 |
| 1093182057 | Callie Jack | Audiologist-Hearing Aid Fitter | 6162 E. Mockingbird Lane, Suite 100, Dallas, TX 75214 | 2015-08-26 |
| 1427436179 | John Martin Whitfill | Internal Medicine | 7040 Tokalon Dr., Dallas, TX 75214 | 2015-05-14 |
| Find all providers in zip 75214 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265077374 | Toothhq Dental Specialists Dallas Pllc | Dentist | 6333 E Mockingbird Ln Ste 254, Dallas, TX 75214-2307 | 2019-11-12 |
| 1295124667 | North Dallas Dental Health Pllc | Dentist | 5465 Blair Road, Suite 200, Dallas, TX 75231 | 2015-01-22 |
| 1033324678 | Hsuch-ming Lee | Dentist | 17752 Preston Rd, Suite 100, Dallas, TX 75252-5699 | 2007-05-14 |
| 1356567218 | Dianne M Thomson | Dentist | 6009 Belt Line Road, Ste #120, Dallas, TX 75254 | 2007-04-18 |
| 1679693790 | Stephen Kenneth Harrel | Dentist | 10246 Midway Rd, #101, Dallas, TX 75229-6233 | 2007-03-30 |
| 1215057989 | Mark Erwin Glover | Dentist | 8226 Douglas Ave Ste 601, Dallas, TX 75225-5928 | 2007-03-29 |
| 1568595502 | Eduardo Tanur | Dentist | 8722 Greenville Ave Ste 100, Dallas, TX 75243-7165 | 2007-03-13 |
| 1881721462 | Deborah Mhari Foyle | Dentist | 6333 E Mockingbird Lane, Suite 254, Dallas, TX 75214 | 2007-02-28 |
| 1295877991 | Frederick E Olden | Dentist | 8215 Westchester Dr Ste 230, Dallas, TX 75225-6116 | 2007-02-12 |
| 1205988441 | Drs. Stukalin, P.a. | Dentist | 5925 Forest Ln Ste 318, Dallas, TX 75230-2776 | 2007-01-17 |
| Find all providers in DALLAS | ||||
Please comment or provide details below to improve the information on DR. SAMUEL DWAYNE ELLSWORTH.
| 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.