1. Home
  2. Directory
  3. California
  4. Moreno Valley
  5. Dentist
  6. NPI Profile

DR. MERVIN LEE ELLSTROM DDS
NPI 1083052138
Dentist in Moreno Valley, CA

Active since June 11, 2013
12900 PERRIS BLVD, SUITE 101, MORENO VALLEY, CA 92553(951) 242-3431(951) 242-7570 Get Directions Write a Review

NPPES record last updated: June 11, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Mervin Lee Ellstrom Dds NPPES

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

DR. MERVIN LEE ELLSTROM DDS (NPI 1083052138) is an individual dentist in Moreno Valley, California, licensed in California (024928) and active in the NPI registry since June 2013.

NPPES Registry Identity

NPI1083052138
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. MERVIN LEE ELLSTROMCredential: DDS
Location Address12900 PERRIS BLVD, SUITE 101Moreno Valley, CA 92553-4135
Mailing Address12900 Perris Blvd, Suite 101Moreno Valley, CA 92553-4135 · (951) 242-3431 · Fax (951) 242-7570
Phone(951) 242-3431
Fax(951) 242-7570
Sole ProprietorYes
Enumeration DateJune 11, 2013
✔ NPI 1083052138 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in CA · 024928
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.
12900 PERRIS BLVD, Moreno Valley, CA 92553
Open in Google Maps ↗

Other Providers at the Same Location NPPES 4

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

KENNETH THOMAS HARRISON D.D.S
Dentist (Orthodontics and Dentofacial Orthopedics)
12900 PERRIS BLVD, STE 201
MORENO VALLEY, CA 92553
Riverside County (951) 242-6229
MOHAMED AMIN HASSAN D.D.S, M.S
Dentist (Periodontics)
12900 PERRIS BLVD, SUITE # 102
MORENO VALLEY, CA 92553
Riverside County (951) 242-4944
MERVIN L. ELLSTROM DDS, INC
Dentist (General Practice)
12900 PERRIS BLVD, SUITE 101
MORENO VALLEY, CA 92553
Riverside County (951) 242-3431
DR. DAVID CASTILLO D.D.S
Dentist
12900 PERRIS BLVD, SUITE 101
MORENO VALLEY, CA 92553
Riverside County (951) 317-9906

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mervin Ellstrom's NPI number?

The NPI number for Mervin Ellstrom is 1083052138. It was assigned to this individual provider in the NPPES registry on June 11, 2013.

Where is Mervin Ellstrom located?

Mervin Ellstrom practices at 12900 Perris Blvd Suite 101, Moreno Valley, CA 92553. The listed phone number is (951) 242-3431.

What is Mervin Ellstrom's specialty?

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

When was this NPI record last updated?

The NPPES record for Mervin Ellstrom was last updated on June 11, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.