DR. EVAN BALE ELLSWORTH DMD
NPI 1003314535
Dentist in Henderson, NV

Q: What is Evan Ellsworth's NPI number?

The NPI number for Evan Ellsworth is 1003314535. It was assigned to this individual provider in the NPPES registry on January 30, 2018.

Q: What is Evan Ellsworth's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Evan Ellsworth was last updated on March 17, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 30, 2018PECOS Enrolled

2660 WINDMILL PKWY, HENDERSON, NV 89074(702) 990-2960 Get Directions Write a Review

NPPES record last updated: March 17, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Evan Bale Ellsworth Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. EVAN BALE ELLSWORTH DMD (NPI 1003314535) is an individual dentist in Henderson, Nevada, licensed in Nevada (7010) and active in the NPI registry since January 2018. He is enrolled in Medicare PECOS and maintains a secondary practice location in Las Vegas.

NPPES Registry Identity

NPI1003314535

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. EVAN BALE ELLSWORTHCredential: DMD

Location Address2660 WINDMILL PKWYHenderson, NV 89074-3385

Mailing Address6127 S Rainbow Blvd Ste 100Las Vegas, NV 89118-3256 · (702) 793-2182

Phone(702) 990-2960

Sole ProprietorYes

Enumeration DateJanuary 30, 2018

Last NPPES UpdateMarch 17, 2019

✔ NPI 1003314535 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in NV · 7010

Definition

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.

2660 WINDMILL PKWY, Henderson, NV 89074

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Secondary Practice Location 1

Location 16127 S Rainbow Blvd Ste 100Las Vegas, NV 89118-3256 · Phone (702) 793-2182

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Anthem Blue Cross and Blue Shield, BEST Life and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Evan Bale Ellsworth Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89074 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.51 typical visit price

range $57.07 – $173.24

Typical copayment $22.12 (range $14.26 – $43.31)

Most-billed visit code 99203

Established Patient

$71.14 typical visit price

range $18.27 – $140.96

Typical copayment $17.78 (range $4.56 – $35.24)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GREAT SMILE DENTAL PLLC

Clinic/Center (Dental)