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Contact Information

CHARLES L ELLIS, DDS, MD
1107 S FIFTH ST STE 250
MEBANE, NC27302-9896
 Phone: 919-563-2873
 Fax: 919-563-2876
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
 

Dentist

122300000X
 

Oral & Maxillofacial Surgery

204E00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for CHARLES L ELLIS · (Male)

NPI Number 1013098698
Status Active
Credentials DDS, MD
Entity Individual
Enumeration date 10/18/2006
Last updated 08/28/2013 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 019022235
  • NC License # 8919
  • VA License # 0101058265
  • VA License # 0401411258
  • NC Medicaid 5914023
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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