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

Dr. Timothy Wayne Ellis Jr., DMD

Individual provider Dentist · NPI 1669149944

Dr. Timothy Wayne Ellis Jr., DMD is a Dentist in Tulsa, Oklahoma. Practices as a sole proprietor. Licensed in Arizona and Oklahoma.

Licensed in
AZ, OK
In the registry since
2021
Specialties on file
2
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

4955 S Peoria Ave
Tulsa, OK 74105-4629
Phone: (918) 895-6568
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 7797 (OK)
Dentist Taxonomy 122300000X · Licence D011115 (AZ)

Record details

NPI number1669149944
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorYes
NPI enumeratedAugust 25, 2021
Last updated in NPPESSeptember 30, 2025
Certification dateSeptember 30, 2025

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