{"npi":"1962571687","type":"NPI-1","status":"active","name":{"display":"Dr. Mona Ellis DMD","other":[],"first":"MONA","last":"ELLIS","middle":"TW","credential":"DMD"},"specialty":{"primary_taxonomy":"122300000X","primary_taxonomy_description":"Dentist","slug":"dentist","schema_org_specialty":null,"all":[{"code":"122300000X","description":"Dentist","primary":true,"state":"SC","license":"2103"}]},"addresses":[{"purpose":"LOCATION","street_1":"1289 BOULEVARD ST","city":"ORANGEBURG","state":"SC","postal_code":"291153401","country_code":"US","phone":"8035330626","fax":"8035330627"},{"purpose":"MAILING","street_1":"1289 BOULEVARD ST","city":"ORANGEBURG","state":"SC","postal_code":"291153401","country_code":"US","phone":"8035330626","fax":"8035330627"}],"license":{"state":"SC","number":"2103"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"ZZ2103","state":"SC","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20140724002297","type_code":"33-19","type_desc":"ORDER AND REFERRING ONLY - ORAL SURGERY","state":"SC","pac_id":"6800012949"}]},"enumeration_date":"2006-11-07","last_updated":"2007-07-08","_meta":{"source":"NPPES","snapshot_date":"2007-07-08","doc_url":"https://findmynpi.com/api"}}