# ELLIS BURKE JARDINE, DMD, PC

> 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
- **Other names:** Advanced Dental Specialists
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720458359
- **Authorized official:** DR. ELLIS BURKE JARDINE DMD (OWNER)
- **Authorized official phone:** (360) 253-9792

## Contact information

- **Practice address:** 406 SE 131ST AVE STE 305, VANCOUVER, WA 98683-4014
- **Practice address phone:** (360) 253-9792
- **Practice address fax:** (360) 604-5266
- **Mailing address:** 406 SE 131ST AVE STE 305, VANCOUVER, WA 98683-4014
- **Mailing address phone:** (360) 253-9792
- **Mailing address fax:** (360) 604-5266

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0700X | Prosthodontics | 60339865 | WA | Yes |

## Other

- **Enumeration date:** 09/24/2015
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | WA 60339865 | WA DENTAL LICENSE | WA |