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General NPI Number Information
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NPI Number | 1861358731
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Entity Type | Individual
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Provider Name | STEPHANIE ELLMAN DDS, MS
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Gender | Female
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 1835 E GUADALUPE RD STE C107
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City | TEMPE
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State | AZ
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Zip | 85283-3277
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Country | US
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Telephone | 480-345-4017
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Fax |
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Provider Business Mailing Address
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Address Line | 4510 E BANNER GATEWAY DR APT 2072
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City | MESA
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State | AZ
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Zip | 85206-4755
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Country | US
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Telephone | 415-871-5742
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Fax |
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | D012703
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License Number State | AZ
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