Shane L Ellsworth in Mcminnville - General Practice
Shane L Ellsworth - NPI 1639379522
Shane L Ellsworth is a General Practice in Mcminnville, Oregon. Shane L Ellsworth practices all healthcare services and medical treatments related to General Practice. The NPI Number for Shane L Ellsworth is 1639379522. The last update date is 2011-01-06.
Shane L Ellsworth's current location address is 704 Ne Evans St, Mcminnville, Oregon. You can contact this provider via phone number 5034721404. The mailing address for Shane L Ellsworth is 704 Ne Evans St, Mcminnville, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shane L Ellsworth |
|---|---|
| Address | 704 Ne Evans St, Mcminnville, Oregon |
| Phone Number | 5034721404 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | DMD |
NPI Number Detail
| NPI Number | 1639379522 |
|---|---|
| Provider Enumeration Date | 2007-07-19 |
| Last Updated Date | 2011-01-06 |
Provider Mailing Address Detail
| Address | 704 Ne Evans St |
|---|---|
| City | Mcminnville |
| State | Oregon (OR) |
| Post Code | 971283926 |
| Phone Number | 5034721404 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | D9517 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4011136 | CT | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Shane L Ellsworth by the Centers for Medicare & Medicaid Services?
The Shane L Ellsworth has been assigned the NPI (National Provider Identifier) 1639379522. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Shane L Ellsworth is geographically located?
The Shane L Ellsworth is physically situated at the following location: 704 Ne Evans St, Mcminnville, OR, 971283926.
What is Shane L Ellsworth's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Shane L Ellsworth is General Practice, and the taxonomy classification code that categorizes this area of expertise is 1223G0001X.
On what date did Shane L Ellsworth receive its 1639379522 assignment from the Centers for Medicare & Medicaid Services?
The Shane L Ellsworth was assigned its 1639379522 on 2007-07-19, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Shane L Ellsworth most recently updated?
The details pertaining to the Shane L Ellsworth, including its address, specialty, and other relevant information, were last refreshed on 2011-01-06.
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