Provider Demographics
NPI:1326077843
Name:ELLASHEK, JAMES EDWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWARD
Last Name:ELLASHEK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3665 STUTZ DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9144
Mailing Address - Country:US
Mailing Address - Phone:330-702-8500
Mailing Address - Fax:
Practice Address - Street 1:3665 STUTZ DR
Practice Address - Street 2:SUITE 2
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-9144
Practice Address - Country:US
Practice Address - Phone:330-702-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-015819122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist