RANDALL WILLIAM ELLIS DDS - NPI 1427026095 - Dentist in Colorado Springs, CO

Q: What is Randall Ellis's NPI number?

The NPI number for Randall Ellis is 1427026095. It was assigned to this individual provider in the NPPES registry on March 9, 2006.

Q: What is Randall Ellis's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Randall Ellis was last updated on June 1, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Randall William Ellis Dds NPPES

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

RANDALL WILLIAM ELLIS DDS (NPI 1427026095) is an individual general practice provider in Colorado Springs, Colorado, licensed in Colorado (DEN-8475) and active in the NPI registry since March 2006.

NPPES Registry Identity

NPI1427026095

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameRANDALL WILLIAM ELLISCredential: DDS

Location Address2859 E FOUNTAIN BLVDColorado Springs, CO 80910-2312

Mailing Address201 W 8th St, Suite 810Pueblo, CO 81003-3038 · (719) 562-4447 · Fax (719) 583-1801

Phone(719) 442-0071

Fax(719) 473-5303

Sole ProprietorNo

Enumeration DateMarch 9, 2006

Last NPPES UpdateJune 1, 2012

✔ NPI 1427026095 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Licenses✔ Licensed in CO · DEN-8475✔ Licensed in ID · D4260✔ Licensed in OK · 4783

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.

2859 E FOUNTAIN BLVD, Colorado Springs, CO 80910

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