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General NPI Number Information
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NPI Number | 1194654459
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Entity Type | Individual
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Provider Name | BROOKE ELIZABETH ELLIS DDS
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Gender | Female
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Dates
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Enumeration Date | 05/14/2026
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Last Update Date | 05/14/2026
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Provider Practice Location Address
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Address Line | 107 COLLEGE ST
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City | WINFIELD
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State | KS
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Zip | 67156-2442
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Country | US
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Telephone | 620-221-9580
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Fax |
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Provider Business Mailing Address
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Address Line | 107 COLLEGE ST
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City | WINFIELD
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State | KS
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Zip | 67156-2442
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Country | US
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Telephone | 620-221-9580
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Fax | 620-262-2444
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 8173
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License Number State | OK
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