Dr Scott Bradley Ellis, DMD is a
Dentist based in Dulles, Virginia. Dr Scott Bradley Ellis is licensed to practice in Virginia (license number 0401411747) and his current practice location is
23520 Overland Dr Ste 134, Dulles, Virginia. He can be reached at his office (for appointments etc.) via phone at
(703) 661-3360.
NPI number for Dr Scott Bradley Ellis is 1093040800 and his current mailing address is 23520 Overland Dr Ste 134, Dulles, Virginia. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1093040800.
Healthcare Provider's Profile
| Full Name | Dr Scott Bradley Ellis |
|---|
| Gender | Male |
|---|
| Speciality | Dentist |
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| Location | 23520 Overland Dr Ste 134, Dulles, Virginia |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1093040800
- Provider Enumeration Date: 10/13/2009
- Last Update Date: 10/13/2009
Medical Identifiers
Medical identifiers for Dr Scott Bradley Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1093040800 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | 0401411747 (Virginia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Scott Bradley Ellis is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Scott Bradley Ellis, DMD
23520 Overland Dr Ste 134,
Dulles, VA 20166-2197
Ph: (703) 661-3360 | Dr Scott Bradley Ellis, DMD
23520 Overland Dr Ste 134,
Dulles, VA 20166-2197
Ph: (703) 661-3360 |
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