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DR. SAMMY DALE ELLIS DMD
NPI 1639112345
Dentist - Oral and Maxillofacial Surgery in Snellville, GA

Active since June 13, 2006
2221 KNOLLWOOD DRIVE, SNELLVILLE, GA 30078(770) 972-7911(770) 978-3767 Get Directions Write a Review

NPPES record last updated: December 11, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Sammy Dale Ellis Dmd NPPES

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

DR. SAMMY DALE ELLIS DMD (NPI 1639112345) is an individual oral and maxillofacial surgery provider in Snellville, Georgia, licensed in Georgia (DN012320) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1639112345
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. SAMMY DALE ELLISCredential: DMD
Location Address2221 KNOLLWOOD DRIVESnellville, GA 30078
Mailing Address2221 Knollwood DriveSnellville, GA 30078 · (770) 972-7911 · Fax (770) 978-3767
Phone(770) 972-7911
Fax(770) 978-3767
Sole ProprietorYes
Enumeration DateJune 13, 2006
Last NPPES UpdateDecember 11, 2012
✔ NPI 1639112345 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in GA · DN012320
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
2221 KNOLLWOOD DRIVE, Snellville, GA 30078
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Other Names 1

Former Name (1)Sammy Dale Ellis

Other Identifiers 2

Medicare ID-Type Unspecified19NCCDSGA
Medicare UPINU94807

Other Providers at the Same Location NPPES 2

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

SNELLVILLE ORAL SURGERY LLC
Dentist (Oral and Maxillofacial Surgery)
2221 KNOLLWOOD DRIVE
SNELLVILLE, GA 30078
Gwinnett County (770) 972-7911
DR. JAMES EUGENE HADDAD JR. DMD
Dentist (Oral and Maxillofacial Surgery)
2221 KNOLLWOOD DRIVE
SNELLVILLE, GA 30078
Gwinnett County (770) 972-7911

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 Sammy Ellis's NPI number?

The NPI number for Sammy Ellis is 1639112345. It was assigned to this individual provider in the NPPES registry on June 13, 2006. The provider is also known as Sammy Dale Ellis.

Where is Sammy Ellis located?

Sammy Ellis practices at 2221 Knollwood Drive, Snellville, GA 30078. The listed phone number is (770) 972-7911.

What is Sammy Ellis's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for Sammy Ellis was last updated on December 11, 2012. 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.