Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Charles Lee Ellis, DDS, MD

Individual provider Dentist · NPI 1013098698

Dr. Charles Lee Ellis, DDS, MD is a Dentist in Green Bay, Wisconsin. Practices as a sole proprietor. Licensed in Illinois, North Carolina and Virginia.

Licensed in
IL, NC, VA
In the registry since
2006
Specialties on file
6
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2353 S Ridge Rd
Green Bay, WI 54304-5069
Phone: (920) 499-0471
Fax: (920) 499-8312
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 8919 (NC)
Dentist Taxonomy 122300000X · Licence 8919 (NC)
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X · Licence 0401411258 (VA)
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X · Licence 019022235 (IL)
Oral & Maxillofacial Surgery (D.M.D.) Taxonomy 204E00000X · Licence 0101058265 (VA)
Oral & Maxillofacial Surgery (D.M.D.) Taxonomy 204E00000X · Licence 8919 (NC)

Record details

NPI number1013098698
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS , MD
Sole proprietorYes
NPI enumeratedOctober 18, 2006
Last updated in NPPESAugust 20, 2025
Mailing address2353 S Ridge Road, Green Bay, WI 54304-5069

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