NPI 1700070331 · live from the CMS NPI Registry
Ellis Orthodontics, LLC
Dentist, Orthodontics and Dentofacial Orthopedics in Dyer, IN. National Provider Identifier 1700070331, active.
NPI record
| NPI | 1700070331 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 275 Us Highway 30, Suite 260, Dyer, IN 46311 |
| Practice phone | 219-322-7645 |
| Enumerated | August 27, 2007 |
| Last updated | August 27, 2007 |
| Authorized official | Lawrence Ellis, Orthodontist |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | 12009958A (IN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.