GRANT ALEXANDER KARLSSON ELLIFSON
NPI 1659076719
Dentist in Milwaukee, WI

Q: What is Grant Karlsson Ellifson's NPI number?

The NPI number for Grant Karlsson Ellifson is 1659076719. It was assigned to this individual provider in the NPPES registry on March 30, 2023.

Q: What is Grant Karlsson Ellifson's specialty?

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

Active since March 30, 2023PECOS Enrolled

1801 W WISCONSIN AVE, MILWAUKEE, WI 53233(608) 422-0516 Get Directions Write a Review

NPPES record last updated: June 21, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 21, 2024, Aug 21, 2023, Mar 30, 2023 (3 updates tracked since 2023).

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About Grant Alexander Karlsson Ellifson NPPES

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

GRANT ALEXANDER KARLSSON ELLIFSON (NPI 1659076719) is an individual dentist in Milwaukee, Wisconsin, licensed in Wisconsin (6001202) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS and maintains a secondary practice location in Madison.

NPPES Registry Identity

NPI1659076719

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameGRANT ALEXANDER KARLSSON ELLIFSON

Location Address1801 W WISCONSIN AVEMilwaukee, WI 53233-2186

Mailing Address2261 N 61st StMilwaukee, WI 53213-1501

Phone(608) 422-0516

Sole ProprietorNo

Enumeration DateMarch 30, 2023

Last NPPES UpdateJune 21, 20243 updates tracked since enumeration

NPPES CertifiedJune 21, 2024

✔ NPI 1659076719 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in WI · 6001202

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.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1801 W WISCONSIN AVE, Milwaukee, WI 53233

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Secondary Practice Location 1

Location 13434 E Washington AveMadison, WI 53704-4155 · Phone (608) 443-5482

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Grant Alexander Karlsson Ellifson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53233 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

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

MARQUETTE UNIVERSITY

Dentist (General Practice)

1801 W WISCONSIN AVE, SUITE 145 B
MILWAUKEE, WI 53233

Milwaukee County (414) 288-5902

AMIR SEIFI DDS

Dentist

1801 W WISCONSIN AVE, MARQUETTE UNIVERSITY SCHOOL OF DENTISTRY. RM 325
MILWAUKEE, WI 53233

Milwaukee County (414) 288-6517

NARINE MIRZOYAN

Dentist (General Practice)