WILLARD JACKSON ELLIS JR.


Address: 3136 Sunset Avenue, Rocky Mount, NC 27804-3650
Phone: 2524439121

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223G0001X Dentist
Specialization: General Practice
4633 NC Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
NC 7992473 05
DEA AE8793336 01

Other Providers WILLARD ELLIS

NPI Name Taxonomy Address Enumeration
1306824503 Willard S Ellis Internal Medicine 2315 Stockton Boulevard, Main Hospital, Sacramento, CA 95817 2006-01-06

Office Location

Street Address 3136 SUNSET AVENUE
City ROCKY MOUNT
State NC
Zip Code 27804-3650

Providers in the same zip code

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 Information

Taxonomy Code 1223G0001X
Grouping Dental Providers
Classification Dentist
Specialization General Practice

Taxonomy Definition

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

Providers in the same taxonomy and city

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

Competitor

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City ROCKY MOUNT
Zip Code 27804

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Dataset Information

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.

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