JERRY R ELLIS DDS PC
NPI 1073516365
Dentist - General Practice in Midlothian, TX

Active since May 31, 2005PECOS Enrolled
404 W MAIN ST, MIDLOTHIAN, TX 76065(972) 775-2345(972) 775-4729 Get Directions Write a Review

NPPES record last updated: March 9, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Jerry R Ellis Dds Pc NPPES

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

JERRY R ELLIS DDS PC (NPI 1073516365) is an individual general practice provider in Midlothian, Texas, licensed in Texas (13742) and active in the NPI registry since May 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073516365
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameJERRY R ELLIS DDS PC
Location Address404 W MAIN STMidlothian, TX 76065-2946
Mailing Address404 W Main StMidlothian, TX 76065-2946 · (972) 775-2345 · Fax (972) 775-4729
Fax(972) 775-4729
Sole ProprietorNo
Enumeration DateMay 31, 2005
Last NPPES UpdateMarch 9, 2023
NPPES CertifiedMarch 9, 2023
NPI 1073516365 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License Licensed in TX · 13742
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.

404 W MAIN ST, Midlothian, TX 76065

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Jerry R Ellis Dds Pc 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 76065 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
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

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

Durable Medical Equipment & Medical Supplies (Customized Equipment)
404 W MAIN ST
MIDLOTHIAN, TX 76065

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1073516365, enumerated as an "individual" on May 31, 2005.

The provider is located at 404 W MAIN ST MIDLOTHIAN, TX 76065 and the phone number is (972) 775-2345.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.