# J. SCOTT ELLIS, D.D.S.

> 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. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457439846
- **Authorized official:** DR. JOHN SCOTT ELLIS D.D.S. (PRESIDENT)
- **Authorized official phone:** (903) 561-3756

## Contact information

- **Practice address:** 5615 OLD BULLARD RD, TYLER, TX 75703-4306
- **Practice address phone:** (903) 561-3756
- **Mailing address:** 5615 OLD BULLARD RD, TYLER, TX 75703-4306
- **Mailing address phone:** (903) 561-3756

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12185 | TX | Yes |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 08/22/2020