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Deactivated NPI 1407921638 Deactivated / Inactive NPI Male Practitioner

Michael Ray Ellis

Dentist • Gladewater, TX

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Michael Ellis has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 22, 2006
NPI Deactivation Date February 21, 2024
Total Practice Duration ~18 Years of Practice (2006 – 2024)

Professional Overview & Biography Verified Profile Summary

Michael Ellis was a registered Dentist practicing in Gladewater, TX. Throughout an active medical career spanning 18 years, Michael Ellis provided care at the practice location at 406 WEST UPSHUR AVE until profile deactivation on 2024-02-21.

Practice Location & Contact Primary Location

Practice Address

406 West Upshur Ave

Gladewater, TX 75647

Telephone 9038452161
Fax 9038457817
Associated Practice Facility / Clinic
🏢 C.l. Kirby, Dds Pllc Facility NPI 1730544834

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Gladewater, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.7 Yrs
Regional Practice Density
1 Specialists

Practicing in Gladewater, TX (6851 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

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License TX 10774

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.

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated February 21, 2024

Record deactivated on February 21, 2024

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 406 WEST UPSHUR AVE, GLADEWATER, TX 75647 (Tel: 9038452161)

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Updated Business Mailing Address July 08, 2007

Registered at 406 WEST UPSHUR AVE, GLADEWATER, TX 75647 (Tel: 9038452161)

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Provider Name / Credentials Updated July 08, 2007

Recorded as MICHAEL ELLIS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #10774 in TX)

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Initial NPI Registration & Enumeration November 22, 2006

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: 1407921638
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 22, 2006
Last Update: July 08, 2007
Deactivation Date: February 21, 2024

Mailing Address

406 West Upshur Ave

Gladewater, TX 75647

Phone: 9038452161

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.