TERRY RANDAL ELLIS (NPI# 1255307831) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255307831 |
| Entity Type | Individual |
| Full Name | TERRY RANDAL ELLIS |
| Credential | DMD |
| Practice Address |
1244 Augusta West Parkway Augusta GA 30909 |
| Practice Telephone | 7068557220 |
| Practice Fax Number | 7068557260 |
| Mailing Telephone | 7068557220 |
| Mailing Fax Number | 7068557260 |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
254190 | MS | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DN011393 | GA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881813814 | Terry Ellis | Physical Therapy Assistant | 1402 Main St, Bloomer, WI 54724-1637 | 2007-04-25 |
| 1699843540 | Terry Allan Ellis | Anesthesiology | 235 West 6th Street, St Marys Regional Medical Center, Reno, NV 89503-4548 | 2006-11-30 |
| Street Address |
1244 AUGUSTA WEST PARKWAY |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912513888 | Lauran Simpson | Behavior Technician | 1237 Augusta West Parkway, Augusta, GA 30909 | 2020-09-16 |
| 1487273884 | Still Perspectives Counseling LLC | Counselor | 1265 Inerstate Prwy, Suite B, Augusta, GA 30909 | 2020-04-15 |
| 1598397838 | Mjra Medical LLC | Psychologist | 3675 J Dewey Gray Cr Ste 300, Augusta, GA 30909 | 2020-02-05 |
| 1003452319 | Danny Robinson | Counselor | 2609 Commons Boulevard, Augusta, GA 30909 | 2019-11-21 |
| 1407498637 | Candice M Cruse | Social Worker | 2609 Commons Blvd, Augusta, GA 30909 | 2019-10-09 |
| 1902363385 | Mary D Jodon | Pharmacist | 3338 Wrightsboro Rd., Augusta, GA 30909 | 2019-02-21 |
| 1447790514 | Burn Critical Care Associates, LLC | Internal Medicine | 3614 J. Dewey Gray Circle, Bldg B., Augusta, GA 30909 | 2017-03-08 |
| 1124561766 | Sasha Latara Mccraw | Counselor | 7303 Palomino Court, Augusta, GA 30909 | 2016-11-30 |
| 1174974620 | Warren Umansky, Ph.d. | Psychologist | 302 Wheeler Executive Ctr, Augusta, GA 30909 | 2016-06-27 |
| 1811358955 | Theodora Mcleskey | Nurse Practitioner | 1215 George C. Wilson Drive, Augusta, GA 30909 | 2016-03-17 |
| Find all providers in zip 30909 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558795930 | Terry R. Ellis, Dmd, PC | Dentist | 1244 Augusta West Pkwy, Augusta, GA 30909-1854 | 2013-08-21 |
| 1831455732 | Rebecca Lynne Paquin | Dentist | Mcg Department of Otolaryngology-head and Neck Surgery, 1120 15th Street, Suite Bp 4109, Augusta, GA 30912 | 2012-04-04 |
| 1487883815 | Sara Khaled Akeel | Dentist | 705 Saint Andrews Drive, Augusta, GA 30909 | 2009-07-07 |
| 1407070006 | Facial and Oral Surgery Associates | Dentist | 5 Community Dr, Augusta, ME 04330-8087 | 2007-04-13 |
| 1790715142 | R. Robert Berube | Dentist | Facial & Oral Surgery Associates, Pa, 5 Community Drive, Augusta, ME 04330 | 2006-07-03 |
| 1093744294 | Edwin Douglas Joy Jr. | Dentist | 1222 George C Wilson Dr, Augusta, GA 30909-4502 | 2006-07-01 |
| 1548205636 | Drs. Peacock & Rafoth, P.C. | Dentist | 3634 Wheeler Rd, Augusta, GA 30909-6518 | 2006-06-20 |
| 1790724763 | Samuel Christopher D'arco | Dentist | 3736 Walton Way Ext, Augusta, GA 30907-2402 | 2006-06-05 |
| 1275195984 | Anh Nguyen | Dentist | 1430 John Wesley Gilbert Drive, Augusta, GA 30912-5042 | 2019-07-02 |
| 1740606375 | Christian Boliere | Dentist | 1430 John Wesley Gilbert Dr, Gc-2112, Augusta, GA 30912-0001 | 2014-03-06 |
| Find all providers in AUGUSTA | ||||
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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.