NPI 1053231464

Easton Grant Ellis, DDS

Practitioner General Practice Dentistry Meridian, ID

Practice location

Address: 1720 W McMillan Rd, Meridian, ID 83646-6892
Phone: (208) 216-1718

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 9981910 (ID)

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Registry record

NPI: 1053231464
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Jul 2026
Record last updated: 16 Jul 2026

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.