WILLARD JACKSON ELLIS JR. (NPI# 1306965140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1306965140 |
Entity Type | Individual |
Full Name | WILLARD JACKSON ELLIS JR. |
Credential | DDS |
Practice Address |
3136 Sunset Avenue Rocky Mount NC 27804-3650 |
Practice Telephone | 2524439121 |
Practice Fax Number | 2524439836 |
Mailing Telephone | 2524439121 |
Mailing Fax Number | 2524439836 |
Enumeration Date | 2007-03-29 |
Last Update Date | 2009-06-26 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223G0001X |
Dentist Specialization: General Practice |
4633 | NC | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | 7992473 | 05 | |
DEA | AE8793336 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306824503 | Willard S Ellis | Internal Medicine | 2315 Stockton Boulevard, Main Hospital, Sacramento, CA 95817 | 2006-01-06 |
Street Address |
3136 SUNSET AVENUE |
City | ROCKY MOUNT |
State | NC |
Zip Code | 27804-3650 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992288419 | Aubrey Kuester | Physical Therapist | Hunter Hills Nursing and Rehab, 7369 Hunter Hill Rd, Rocky Mount, NC 27804 | 2018-09-11 |
1134636475 | New Beginning Family Services of Nc | Clinic/Center | 600 Tiffany Blvd Ste H, Rocky Mount, NC 27804 | 2018-01-09 |
1033640776 | Simply Frazier Beauty Salon | Specialist | 1141 Jeffreys Rd, Rocky Mount, NC 27804 | 2017-03-24 |
1164961942 | Family Care Partners of North Carolina, Pllc | Internal Medicine | 1041 Noel Ln. Ste 105, Rocky Mt., NC 27804 | 2017-02-14 |
1164834867 | Ward Specialty Pharmacy LLC | Pharmacy | 3646 Sunset Ave, Suite 110 Barkley Square, Rocky Mount, NC 27804 | 2014-05-29 |
1891107678 | Patrick Ignacio | Pharmacist | 3646 Sunset Ave., Suite 110, Rocky Mount, NC 27804 | 2014-05-28 |
1023437795 | Down East Hearing | Hearing Aid Equipment | 1356 Benvenue Rd., Rocky Mount, NC 27804 | 2014-04-10 |
1659710416 | Sterling House of Rocky Mount | Assisted Living Facility | 650 Goldrock Road, Sterling House of Rocky Mount, Rocky Mount, NC 27804 | 2013-06-14 |
1700223609 | Keenya Anderson Staten | Nurse Practitioner | 1701 Sunset Ave Ste 105c, Rocky Mount, NC 27804 | 2013-05-31 |
1578844528 | Nathan Thomas Long | Pharmacist | 300 N Grace St Ste 150, Rocky Mount, NC 27804 | 2011-09-05 |
Find all providers in zip 27804 |
Taxonomy Code | 1223G0001X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | General Practice |
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
Notes: Source: Academy of General Dentistry |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568843928 | Jason Ross Duke | Dentist | 1543 Benvenue Rd, Rocky Mount, NC 27804-6383 | 2015-06-11 |
1710285366 | Arthur W. Lewis | Dentist | 105 Bramblebush Ct, Rocky Mount, NC 27804-2152 | 2011-03-07 |
1548465925 | Harrold and Associates Dental Care | Dentist | 105 Wayfarer Court, Rocky Mount, NC 27801 | 2007-06-18 |
1902026693 | Drs. Hunt and Hunt, Pa | Dentist | 111 Candlewood Rd, Rocky Mount, NC 27804-2105 | 2007-04-26 |
1033243027 | Charles Richard Burt | Dentist | 1175 Franklin St, Rocky Mount, VA 24151-1248 | 2007-03-14 |
1114067154 | Lucas J. Nazario | Dentist | 2325b Sunset Ave, Rocky Mount, NC 27804-2529 | 2007-02-07 |
1285787390 | Brian S. Alexander | Dentist | 1656 N Main St, Rocky Mount, VA 24151-2238 | 2007-01-19 |
1275683542 | Doris Knight Thorne | Dentist | 3729 Westridge Circle Dr, Rocky Mount, NC 27804-3335 | 2007-01-11 |
1093878886 | Barry Daniel Belton | Dentist | 1512 S Winstead Ave, Rocky Mount, NC 27803-1650 | 2006-12-19 |
1215096193 | Jinesh S. Patel, D.m.d., P.a. | Dentist | 4068 Capital Dr, Rocky Mount, NC 27804-3123 | 2006-12-07 |
Find all providers in ROCKY MOUNT |
City | ROCKY MOUNT |
Zip Code | 27804 |
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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.