Individual provider · Type 1 NPI

Timothy Wayne Ellis Jr., DMD

Dentist · Tulsa, OK

NPI number 1669149944 Active

Practice location

4955 S Peoria Ave
Tulsa, OK 74105-4629

Mailing address

3929 W Angela Dr
Glendale, AZ 85308-3012

Specialties and licenses

TaxonomyCodeLicense
Dentist 122300000XD011115 (AZ)
Dentist Primary 122300000X7797 (OK)

Dentist: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requiremen…

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About NPI 1669149944

Timothy Wayne Ellis Jr., DMD's National Provider Identifier is 1669149944, issued on Aug 25, 2021. The primary taxonomy on file is Dentist (122300000X), and the practice location is in Tulsa, OK. The record was last updated on Sep 30, 2025.