Individual provider · Type 1 NPI

Samuel Dwayne Ellsworth, DDS

Periodontics · Dallas, TX

NPI number 1891097168 Active

Practice location

6333 E Mockingbird Ln, Suite 254
Dallas, TX 75214-2692

Call (214) 827-9500 Map

Fax (214) 827-9502

Specialties and licenses

TaxonomyCodeLicense
Dentist 122300000X25488 (TX)
Periodontics Primary 1223P0300X25488 (TX)

Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

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About NPI 1891097168

Samuel Dwayne Ellsworth, DDS's National Provider Identifier is 1891097168, issued on Nov 18, 2010. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Dallas, TX. The record was last updated on Feb 18, 2014.