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ELAINE ELLIS CENTER OF HEALTH
NPI 1366243768
Clinic/Center - Dental in Washington, DC

Active since March 21, 2025CLIA 09D2040094 · Waiver
1627 KENILWORTH AVE NE, WASHINGTON, DC 20019(202) 803-2340(202) 803-2350 Get Directions Write a Review

NPPES record last updated: March 21, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Elaine Ellis Center Of Health NPPES

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

ELAINE ELLIS CENTER OF HEALTH (NPI 1366243768) is a healthcare organization registered as a dental in Washington, District Of Columbia and active in the NPI registry since March 2025. The organization holds a CLIA Waiver certificate valid through April 22, 2028 and lists Jacquelyn Renee Walker, Ceo, as its authorized official.

NPPES Registry Identity

NPI1366243768
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameELAINE ELLIS CENTER OF HEALTH
Location Address1627 KENILWORTH AVE NEWashington, DC 20019-2010
Mailing Address1627 Kenilworth Ave NeWashington, DC 20019-2010 · (202) 803-2340 · Fax (202) 803-2350
Phone(202) 803-2340
Fax(202) 803-2350
Organization SubpartNo
Authorized OfficialJacquelyn Renee WalkerCeo · (202) 803-2340
Enumeration DateMarch 21, 2025
NPPES CertifiedMarch 21, 2025
✔ NPI 1366243768 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
1627 KENILWORTH AVE NE, Washington, DC 20019
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 09D2040094

Elaine Ellis Center Of Health · Washington, DC
Active · expires Apr 22, 2028
CLIA Number09D2040094
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateApril 23, 2026
Certificate Expiration DateApril 22, 2028
Laboratory DirectorGwendolyn Dunmore
Laboratory Phone(202) 803-2340
Laboratory LocationElaine Ellis Center Of Health1627 Kenilworth Avenue, NE, Washington, DC 20019
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

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

DR. ALLISON DENISE RAYMOND DDS
Dentist (General Practice)
1627 KENILWORTH AVE NE
WASHINGTON, DC 20019
District of Columbia (202) 803-2340
DALE MARSHALL CAC I, CAC-AD, LGPC
Counselor (Addiction (Substance Use Disorder))
1627 KENILWORTH AVE NE
WASHINGTON, DC 20019
District of Columbia (202) 803-2340
MEDHIN G GEBREAMLAK NP
Nurse Practitioner (Family)
1627 KENILWORTH AVE NE
WASHINGTON, DC 20019
District of Columbia (703) 732-7126
DR. MAHIRA TAMBOO DMD
Dentist (General Practice)
1627 KENILWORTH AVE NE
WASHINGTON, DC 20019
District of Columbia (202) 803-2340
VERNELL GAIL THOMAS RDH
Dental Hygienist
1627 KENILWORTH AVE NE
WASHINGTON, DC 20019
District of Columbia (202) 803-2340
ELAINE ELLIS CENTER OF HEALTH, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
1627 KENILWORTH AVE NE
WASHINGTON, DC 20019
District of Columbia (202) 425-2313
SONIA HAIDER MD
Family Medicine
1627 KENILWORTH AVE NE
WASHINGTON, DC 20019
District of Columbia (202) 803-2350
AFSHAN REHMAN MD
Family Medicine
1627 KENILWORTH AVE NE
WASHINGTON, DC 20019
District of Columbia (202) 803-2340

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 Elaine Ellis Center Of Health's NPI number?

The NPI number for Elaine Ellis Center Of Health is 1366243768. It was assigned to this organization in the NPPES registry on March 21, 2025.

Where is Elaine Ellis Center Of Health located?

Elaine Ellis Center Of Health is located at 1627 Kenilworth Ave NE, Washington, DC 20019. The listed phone number is (202) 803-2340.

What is Elaine Ellis Center Of Health's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

Does Elaine Ellis Center Of Health hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 09D2040094) is associated with this NPI, valid through April 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Elaine Ellis Center Of Health was last updated on March 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.