Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Ellis Chan Back, DDS

Individual provider Dentist · NPI 1841064094

Dr. Ellis Chan Back, DDS is a Dentist in Vallejo, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2023
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.

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Practice location Address checks out

3587 Sonoma Blvd
Vallejo, CA 94590-2945
Phone: (925) 683-4799
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 109664 (CA)

Record details

NPI number1841064094
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedNovember 8, 2023
Last updated in NPPESNovember 8, 2023
Certification dateNovember 8, 2023
Mailing address962 El Cajon Dr, Danville, CA 94526-1935

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