Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Individual
TERRY RANDAL ELLIS
Active
Individual
TERRY RANDAL ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
254190
MS
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN011393
GA
Other
Enumeration date
02/24/2006
Last updated
07/13/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up