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

Dr. Mervin Lee Ellstrom, DDS

Individual provider Dentist · NPI 1083052138

Dr. Mervin Lee Ellstrom, DDS is a Dentist in Moreno Valley, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2013
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.

See every abbreviation used in this directory →

Practice location Address checks out

12900 Perris Blvd Ste 101
Moreno Valley, CA 92553-4135
Phone: (951) 242-3431
Fax: (951) 242-7570
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 024928 (CA)

Record details

NPI number1083052138
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedJune 11, 2013
Last updated in NPPESJune 11, 2013
Mailing address12900 Perris Blvd, Suite 101, Moreno Valley, CA 92553-4135

Other providers in Moreno Valley