DR. JORDAN MICHAEL ELLIS (NPI# 1902398068) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902398068 |
| Entity Type | Individual |
| Full Name | DR. JORDAN MICHAEL ELLIS |
| Credential | DMD |
| Practice Address |
1900 East Main St Danville IL 61832-6183 |
| Mailing Address |
1118 Douglas St Alton IL 62002-2219 |
| Practice Telephone | 2175543000 |
| Mailing Telephone | 2177999533 |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2020-07-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 019031635 | IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891239901 | Jordan Ellis | Specialist/Technologist | 5814 S 105th St, Omaha, NE 68127-2909 | 2016-12-08 |
| 1144636275 | Jordan Marie Ellis | Nurse Practitioner | 1642 Westgate Cir Ste 202, Brentwood, TN 37027-8195 | 2014-07-09 |
| 1972167161 | Jordan Ellis | Psychologist | 1100 Wilford Hall Loop, Bldg. 4554, 59 Mdw/gme, Jbsa Lackland, Jbsa Lackland, TX 78236 | 2019-04-24 |
| 1720534696 | Jordan E Ellis | Nurse Anesthetist, Certified Registered | 1836 South Ave, La Crosse, WI 54601-5429 | 2016-08-30 |
| Street Address |
1900 EAST MAIN ST |
| City | DANVILLE |
| State | IL |
| Zip Code | 61832-6183 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164515672 | Meaza Mulugeta Mengistu | Internal Medicine | 1900 East Main St, Danville, IL 61832 | 2006-10-02 |
| 1114575602 | Elizabeth Ann Osborne | Technician | 1900 East Main St, Danville, IL 61832 | 2019-08-28 |
| 1164685533 | Victoria Lee Dunavan | Social Worker | 1900 East Main St, Danville, IL 61832 | 2008-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316593957 | Margaret Jean Heath | Technician | 310 N North St, Danville, IL 61832 | 2019-08-09 |
| 1215494620 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 3653 N Vermilion Dr, Danville, IL 61832 | 2019-02-22 |
| 1003263104 | Bayview Family Clinic | Nurse Practitioner | 3595 N Vermillion Street, Danville, IL 61832 | 2016-05-18 |
| 1194179499 | Kinisha Vasser | Social Worker | 1900 E. Main Steet, Danville, IL 61832 | 2016-04-22 |
| 1023497237 | Alpha Omega Counseling Services | Community/Behavioral Health | 120 N Vermilion, Danville, IL 61832 | 2015-05-20 |
| 1437557568 | Terri D. Dunn | Hearing Instrument Specialist | 733 N. Logan #4, Audibel Hearing Aids, Danville, IL 61832 | 2014-12-05 |
| 1518361682 | Rosemarie Renee Eck | Nurse Practitioner | 1900 E Main St, Bldg 101-171, Va Illiana Health Care System, Danville, IL 61832 | 2014-10-17 |
| 1497181747 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 3649 N. Vermillion St., Danville, IL 61832 | 2013-09-18 |
| 1598000770 | Bayview Family Clinic Ltd | Health Maintenance Organization | 405 N. Sheridan St., Danville, IL 61832 | 2012-11-29 |
| 1992052666 | Katharine Lorraine Lerner | Pharmacist | 3649 N Vermilion St, Danville, IL 61832 | 2012-08-13 |
| Find all providers in zip 61832 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225637382 | Manveen Kaur Sandhu | Dentist | 387 Elworthy Ranch Cir, Danville, CA 94526-4855 | 2020-10-20 |
| 1356901714 | Brent Whittaker | Dentist | 709 South Market Street, Danville, OH 43014 | 2019-06-18 |
| 1992298913 | Mohamed Alsharea | Dentist | 2811 N Vermilion St, Danville, IL 61832-1433 | 2018-06-13 |
| 1619478781 | Olalekan I. Okunuga, Dds, P.C. | Dentist | 3284 Riverside Dr, Danville, VA 24541-3429 | 2018-02-23 |
| 1801315106 | Shailaja Singh Dds Inc | Dentist | 185 Front St Ste 106, Danville, CA 94526-3323 | 2017-09-18 |
| 1124407895 | Knox County Dental, Aaron F. Lerg D.d.s. Inc. | Dentist | 706 S. Market Street, Danville, OH 43014 | 2015-05-27 |
| 1649602228 | Susan Hale Couzens | Dentist | 435 Whirlaway Dr, Danville, KY 40422 | 2013-08-06 |
| 1871937706 | Anthony Lizano | Dentist | 400 El Cerro Blvd Ste 202, Danville, CA 94526-1731 | 2013-04-22 |
| 1427392521 | Karam Abdou | Dentist | 105 Center Ct, Danville, CA 94506-1186 | 2012-11-15 |
| 1326308990 | Renee Catherine Davis Kilty | Dentist | 1080 Ben Ali Drive Ste A, Danville, KY 40422-2547 | 2012-05-16 |
| Find all providers in DANVILLE | ||||
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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.