Provider Demographics
NPI:1295310118
Name:JARED S ELLINGER DDS PLLC
Entity type:Organization
Organization Name:JARED S ELLINGER DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:ELLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:419-344-9535
Mailing Address - Street 1:127 NORTHCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-4174
Mailing Address - Country:US
Mailing Address - Phone:419-344-9535
Mailing Address - Fax:
Practice Address - Street 1:50 GRAND ST
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-1680
Practice Address - Country:US
Practice Address - Phone:517-278-8289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty