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Active NPI 1669149944 Individual Practitioner Male Practitioner

Dr. Timothy Wayne Ellis , DMD

Dentist • Tulsa, OK

Professional Overview & Biography Verified Profile Summary

Dr. Timothy Ellis, DMD is a registered healthcare professional specializing in Dentist in Tulsa, OK. Practice services are available at 4955 S PEORIA AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4955 S Peoria Ave

Tulsa, OK 741054629

Telephone 9188956568
Associated Practice Facility / Clinic
🏢 Hero Dental Of Tulsa Pc Facility NPI 1164798757

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Tulsa, OK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 11.6 Yrs
Regional Practice Density
147 Specialists

Practicing in Tulsa, OK (1115 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-09-30
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License OK 7797

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Dentist

NUCC Taxonomy Code: 122300000X

State License AZ D011115

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1093504292

Doctor of Dental Surgery

Dr. Brianna Jones , DDS

Dentist - General Practice

NPI 1740018852

Doctor of Dental Surgery

Dr. Shannon Green , DDS

Dentist - Oral and Maxillofacial Surgery

NPI 1811550999

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Practice Location March 07, 2024

Registered at 4955 S PEORIA AVE, TULSA, OK 741054629 (Tel: 9188956568)

NPI Profile Active August 25, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location August 25, 2021

Registered at 3929 W ANGELA DR, GLENDALE, AZ 853083012 (Tel: 7204274909)

📍
Updated Business Mailing Address August 25, 2021

Registered at 3929 W ANGELA DR, GLENDALE, AZ 853083012 (Tel: 7204274909)

👤
Provider Name / Credentials Updated August 25, 2021

Recorded as TIMOTHY ELLIS, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 25, 2021

Dentist (License #D011115 in AZ)

🟢
Initial NPI Registration & Enumeration August 25, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1669149944
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 25, 2021
Last Update: September 30, 2025
Sole Proprietor: Yes

Mailing Address

3929 W Angela Dr

Glendale, AZ 853083012

Phone: 7204274909

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.