IndividualActive
Charles Ellis, DDS, MD
NPI 1013098698 · Oral and Maxillofacial Surgery (Dentist) · Green Bay, WI
Provider details
- NPI number
- 1013098698
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Credential
- DDS, MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 8919 (NC)
Specialties & taxonomies
Dental Providers
Dental Providers
Dental Providers
Dental Providers
Allopathic & Osteopathic Physicians
Practice location
2353 S Ridge Road
Green Bay, WI 54304-5069
Phone: (920) 499-0471
Fax: (920) 499-8312
Approximate (ZIP-level) locationGet directions
Mailing address
2353 S Ridge Road
Green Bay, WI 54304-5069
Registry dates
- Enumerated
- 2006-10-18
- Last updated
- 2025-08-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.