Ellis Chan Back, DDS

Dentist · Vallejo, CA

Individual Active NPI

NPI number 1841064094

Practice location

3587 Sonoma Blvd
Vallejo, CA 94590-2945
Phone
(925) 683-4799

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NPI record

NPI
1841064094
Entity type
Individual (Type 1)
Enumeration date
November 8, 2023
Last updated
November 8, 2023
Certified
November 8, 2023
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 109664 CA

Mailing address

962 El Cajon Dr
Danville, CA 94526-1935
Phone
(925) 683-4799

About Dr. Back

Ellis Chan Back, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 3587 Sonoma Blvd, Vallejo, CA 94590-2945. The NPI number 1841064094 was assigned on November 8, 2023 and the record was last updated on November 8, 2023.

Dr. Back lists a license in the registry: #109664 (CA) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Ellis Chan Back, DDS?

The NPI number is 1841064094.

What is the phone number of Dr. Back?

The phone number listed for the practice location is (925) 683-4799.

Where is Dr. Back located?

3587 Sonoma Blvd, Vallejo, CA 94590-2945.

What is the taxonomy code for Dr. Back?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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