CHARLES ELLIS, DDS, MD
Oral and Maxillofacial Surgery (Dentist) · GREEN BAY, WI
Individual Active Opted out of Medicare NPI 1013098698
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | ✓ | 8919 | NC |
| Dentist | 122300000X | 8919 | NC | |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 0401411258 | VA | |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 019022235 | IL | |
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | 0101058265 | VA | |
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | 8919 | NC |
Medicare eligibility
- Part B
- Yes
- DME
- Yes
- Home health
- Yes
- Power mobility
- No
- Hospice
- Yes
Opted out of Medicare (Dentist), effective 2021-05-01 through 2027-05-01.
Other Oral and Maxillofacial Surgery (Dentist) providers in Wisconsin
- NPI 1427638170
- NPI 1427270776
- NPI 1861592529
- NPI 1013921196
- NPI 1619174877
- NPI 1396001483
- NPI 1447264502
- NPI 1124049820
See all Oral and Maxillofacial Surgery (Dentist) providers in Wisconsin →
Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.