Individual provider · Type 1 NPI
Charles Lee Ellis, DDS, MD
Oral and Maxillofacial Surgery (Dentist) · Green Bay, WI
NPI number
1013098698
Active
Practice location
2353 S Ridge Road
Green Bay, WI 54304-5069
Fax (920) 499-8312
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| 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) |
| Oral and Maxillofacial Surgery (Dentist) Primary | 1223S0112X | 8919 (NC) |
Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Another provider at this address
Other oral and maxillofacial surgery (dentist) providers in Green Bay
- Bradley S. Koch, DDSOral and Maxillofacial Surgery (Dentist) Green Bay, WI NPI 1013921196
- Krista S. PrimleyOral and Maxillofacial Surgery (Dentist) Green Bay, WI NPI 1073013025
- Timothy Jason Lemoine, DDSOral and Maxillofacial Surgery (Dentist) Green Bay, WI NPI 1093394777
- Gregory W. Welsh, DDSOral and Maxillofacial Surgery (Dentist) Green Bay, WI NPI 1124049820
- Chad Randall Seubert, D.D.SOral and Maxillofacial Surgery (Dentist) Green Bay, WI NPI 1396001483
- Ardit Haxhia, DDSOral and Maxillofacial Surgery (Dentist) Green Bay, WI NPI 1427638170
- Trystan Richard Wiedow, DDSOral and Maxillofacial Surgery (Dentist) Green Bay, WI NPI 1427639038
- David L. Lemoine, DDSOral and Maxillofacial Surgery (Dentist) Green Bay, WI NPI 1447264502
About NPI 1013098698
Charles Lee Ellis, DDS, MD's National Provider Identifier is 1013098698, issued on Oct 18, 2006. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Green Bay, WI. The record was last updated on Aug 20, 2025.