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DR. THOMAS ALAN ELLISOR D.D.S.
NPI 1649617838
Dentist in Lake Jackson, TX

Active since May 28, 2013Opted out of Medicare · through Apr 13, 2027
103 N DIXIE DR, LAKE JACKSON, TX 77566(979) 297-6438 Get Directions Write a Review

NPPES record last updated: May 28, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Thomas Alan Ellisor D.d.s. NPPES

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

DR. THOMAS ALAN ELLISOR D.D.S. (NPI 1649617838) is an individual dentist in Lake Jackson, Texas, licensed in Texas (28931) and active in the NPI registry since May 2013. He has opted out of Medicare through April 13, 2027.

NPPES Registry Identity

NPI1649617838
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. THOMAS ALAN ELLISORCredential: D.D.S.
Location Address103 N DIXIE DRLake Jackson, TX 77566-5940
Mailing Address137 W Phillips RdAngleton, TX 77515-9370 · (254) 495-1376
Phone(979) 297-6438
Sole ProprietorNo
Enumeration DateMay 28, 2013
✔ NPI 1649617838 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in TX · 28931
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.
103 N DIXIE DR, Lake Jackson, TX 77566
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Thomas Alan Ellisor D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 13, 2021 through April 13, 2027.

Opt-Out Effective DateApril 13, 2021
Opt-Out In Effect ThroughApril 13, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 5

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

CYNTHIA OVERHOLSER DDS
Clinic/Center (Dental)
103 N DIXIE DR
LAKE JACKSON, TX 77566
Brazoria County (979) 297-6438
MAX CARROLL MAYS DDS
Dentist (General Practice)
103 N DIXIE DR
LAKE JACKSON, TX 77566
Brazoria County (979) 297-6438
LAKE JACKSON FAMILY DENTISTRY PLLC
Clinic/Center (Dental)
103 N DIXIE DR
LAKE JACKSON, TX 77566
Brazoria County (979) 297-6438
GARY DAWAYNE WEEKS D.D.S.
Dentist (General Practice)
103 N DIXIE DR
LAKE JACKSON, TX 77566
Brazoria County (979) 297-6438
DR. CYNTHIA ANNE OVERHOLSER D.D.S.
Dentist (General Practice)
103 N DIXIE DR
LAKE JACKSON, TX 77566
Brazoria County (979) 297-6438

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 Thomas Ellisor's NPI number?

The NPI number for Thomas Ellisor is 1649617838. It was assigned to this individual provider in the NPPES registry on May 28, 2013.

Where is Thomas Ellisor located?

Thomas Ellisor practices at 103 N Dixie Dr, Lake Jackson, TX 77566. The listed phone number is (979) 297-6438.

What is Thomas Ellisor's specialty?

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

Is Thomas Ellisor enrolled in Medicare?

No. Thomas Ellisor has opted out of Medicare through April 13, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Thomas Ellisor accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 8 other insurers list Thomas Ellisor as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Thomas Ellisor was last updated on May 28, 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.