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

Dr. Michael Barry Ellis, DMD, PA

Individual provider General Practice Dentistry · NPI 1619995743

Dr. Michael Barry Ellis, DMD, PA is a General Practice Dentistry in Vicksburg, Mississippi. Practices as a sole proprietor. Licensed in Mississippi.

Licensed in
MS
In the registry since
2006
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1008 Mission Park Dr
Vicksburg, MS 39180-3735
Phone: (601) 629-4100
Fax: (601) 629-4101
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 204783 (MS)

Record details

NPI number1619995743
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD , PA
Sole proprietorYes
NPI enumeratedJuly 17, 2006
Last updated in NPPESJuly 8, 2007

Other providers in Vicksburg