DR. MARK ALLEN ELLIS (NPI# 1184719262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184719262 |
| Entity Type | Individual |
| Full Name | DR. MARK ALLEN ELLIS |
| Credential | DDS |
| Practice Address |
910 Averitt Rd Greenwood IN 46143-9540 |
| Practice Telephone | 3178599450 |
| Practice Fax Number | 3178599475 |
| Mailing Telephone | 3178599450 |
| Mailing Fax Number | 3178599475 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2018-12-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
12010547A | IN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200500300 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972897080 | Mark Ellis | Podiatrist | 12592 S 150 E, Draper, UT 84020-8611 | 2011-06-06 |
| 1659682219 | Mark Kenneth Ellis | Emergency Medicine | 2 5th Ave Apt 2d, New York, NY 10011-8832 | 2010-06-29 |
| 1174661672 | Mark Joseph Ellis | Chiropractor | 41 Western Avenue, Rochester, NH 03867 | 2007-02-05 |
| 1336204171 | Mark J Ellis | Respiratory Therapist, Certified | 1101 Jefferson Blvd, Hagerstown, MD 21742-5037 | 2006-12-22 |
| 1437240124 | Mark Owen Ellis | Podiatrist | 582 22nd Street, Astoria, OR 97103 | 2006-09-27 |
| 1083632244 | Mark Brian Ellis | Family Medicine | 1018 Rucker Blvd, Ste A, Enterprise, AL 36330-3675 | 2006-07-17 |
| 1265426894 | Mark Alan Ellis | Dentist | 951 Riverfront Pkwy, Suite 302, Chattanooga, TN 37402-2185 | 2005-09-09 |
| 1316580509 | Mark Duane Ellis | Licensed Practical Nurse | 2600 Se Belmont St, Portland, OR 97214-2916 | 2019-10-21 |
| 1629427752 | Mark Andrew Ellis | Otolaryngology | 169 Ashley Ave, Room 202 Main Hospital, Msc 333, Charleston, SC 29425-9080 | 2016-06-09 |
| 1366808677 | Mark Ellis | Behavioral Analyst | 453 King St, Cocoa, FL 32922-7621 | 2016-01-04 |
| Street Address |
910 AVERITT RD |
| City | GREENWOOD |
| State | IN |
| Zip Code | 46143-9540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395299 | Tiffany Smirat | Pharmacist | 882 S Sr 135, Greenwood, IN 46143 | 2020-10-27 |
| 1083250138 | Benajmin Thomas Nyboer | Pharmacist | 5961 North State Road 135, Kroger Pharmacy, Greenwood, IN 46143 | 2019-11-25 |
| 1609417260 | Orthopaedics-indianapolis, Inc | Orthopaedic Surgery | 1579 Olive Branch Parke Lane, Suite 130, Greenwood, IN 46143 | 2019-10-04 |
| 1194282525 | Homebased Mental Health Service | Case Management | 2244 Blossom Dr, Greenwood, IN 46143 | 2019-02-21 |
| 1710478078 | Anne E Packard | Pharmacist | 333 E County Line Rd # 101, Greenwood, IN 46143 | 2018-05-22 |
| 1033607924 | Ez Clinic Inc. | Nurse Practitioner | 494 S Emerson Ave Ste I, Greenwood, IN 46143 | 2018-04-25 |
| 1891246633 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 5961 N Sr 135, Greenwood, IN 46143 | 2016-10-17 |
| 1477919637 | Ourhealth Physicians Group, LLC | Clinic/Center | 1273 N Emerson Ave Ste H, Greenwood, IN 46143 | 2016-01-04 |
| 1003212655 | American Health Network of Indiana, LLC | Non-Pharmacy Dispensing Site | 2355 Endress Place St A, Healthy Measures Wellness Clinic, Greenwood, IN 46143 | 2014-11-10 |
| 1265831366 | Katie D'agosto | Counselor | 3000 S State Road 135 Ste 230, Greenwood, IN 46143 | 2014-08-14 |
| Find all providers in zip 46143 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225406960 | Jim Nasim | Dentist | 101 West Durst Avenue, Greenwood, SC 29649 | 2015-09-11 |
| 1730610833 | Park Pediatric Dentistry LLC | Dentist | 1700 W Smith Valley Rd, Suite B1, Greenwood, IN 46142-1599 | 2017-03-21 |
| 1215188388 | Pediatric Dentistry of Greenwood, P.a. | Dentist | 1202b Hwy 72 W, Greenwood, SC 29649-1816 | 2008-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477186732 | Poplar Pediatric Dentistry LLC | Dentist | 6741 Lexington Cir, Zionsville, IN 46077-9164 | 2020-02-14 |
| 1265074710 | Hendricks Pediatric Dentistry, LLC | Dentist | 1557 Windview, Brownsburg, IN 46112-7641 | 2019-10-16 |
| 1760048748 | Kids Dentistree of In, LLC | Dentist | 1602 W Mcclain Ave, Scottsburg, IN 47170-1161 | 2019-05-15 |
| 1134691090 | Dentistry Just for Kids and Orthodontics, LLC | Dentist | 1107 Ohio St, Terre Haute, IN 47807-3817 | 2018-12-17 |
| 1588159339 | Kids Dentistree of In, LLC | Dentist | 7900 E Us Highway 36 Ste K, Avon, IN 46123-7791 | 2018-06-25 |
| 1285128512 | Schulten Pediatric Dentistry - New Albany LLC | Dentist | 4317 Charlestown Rd, New Albany, IN 47150-8506 | 2018-06-20 |
| 1255843116 | John A. Bozc, D.d.s. PC | Dentist | 520 W Navajo St, West Lafayette, IN 47906-1999 | 2017-11-01 |
| 1316463607 | Emhardt Pediatric Dentistry LLC | Dentist | 1818 N Riley Hwy Ste B, Shelbyville, IN 46176-8572 | 2017-08-17 |
| 1194245225 | Sara Gholam | Dentist | 1121 W Michigan St Rm 280b, Indianapolis, IN 46202 | 2017-06-20 |
| 1245788066 | Eric Ladd, D.d.s. | Dentist | 555 W Us Highway 30, Schererville, IN 46375-2650 | 2016-09-21 |
| 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.