Individual
STEPHANIE ELLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
1835 E GUADALUPE RD STE C107, TEMPE, AZ 85283-3277
(480) 345-4017
Mailing address
4510 E BANNER GATEWAY DR APT 2072, MESA, AZ 85206-4755
(415) 871-5742
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D012703
AZ
Other
Enumeration date
01/05/2026
Last updated
01/05/2026
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