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General NPI Number Information
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NPI Number | 1376618199
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Entity Type | Organization
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Legal Business Name | JAMES R ELLIS DDS INC
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 745 PLUMAS ST
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City | YUBA CITY
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State | CA
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Zip | 95991
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Country | US
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Telephone | 530-671-9240
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Fax | 530-671-1098
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Provider Business Mailing Address
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Address Line | 745 PLUMAS ST OR P. O. BOX Z
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City | YUBA CITY
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State | CA
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Zip | 95991-4437
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Country | US
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Telephone | 530-671-9240
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Fax | 530-671-1098
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES RICHARD ELLIS
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Credential | DDS
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Telephone | 530-671-9240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | D21563
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License Number State | CA
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