NPI 1003314535

Evan Bale Ellsworth, DMD

Practitioner Dentist Henderson, NV

Practice location

Address: 2660 Windmill Pkwy, Henderson, NV 89074-3385
Phone: (702) 990-2960
Mailing address: 6127 S Rainbow Blvd STE 100, Las Vegas, NV 89118-3256

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 7010 (NV)

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Registry record

NPI: 1003314535
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 Jan 2018
Record last updated: 17 Mar 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.