Kevin Gernon Eatmon, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DNO12725 Issued in GA

Practice address

275 14TH St NW Ste 100
Atlanta, GA 30318-9100

Phone

(404) 254-0149

Fax

(404) 254-0847

NPI assigned

Nov 13, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1003987884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2931 GREY MOSS PASS",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300976274",
            "telephone_number": "404-254-0149",
            "fax_number": "404-254-0847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 14TH ST NW STE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303189100",
            "telephone_number": "404-254-0149",
            "fax_number": "404-254-0847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6600 Abercorn St",
            "address_2": "Ste. 110",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314055800",
            "country_code": "US",
            "telephone_number": "912-354-3880",
            "fax_number": "912-356-5909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EATMON",
        "first_name": "KEVIN",
        "middle_name": "GERNON",
        "name_prefix": "Mr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "DNO12725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eastlake Pharmacy Inc
• Jennifer Browning Eastman, M.ED., CCC-SLP
• Cassandra Easton, CPT, CHC NUTRITIONIS
• Kathryn E Easton, PHARMD
• Jasmin Eatman
• Elizabeth Anne Eaton, APRN, CPNP
• Lakisha S Eaton, M.D.
• Lynnfield Eaton, CPNP
• Madison Moore Eaton, PA
• Olivia Ann Eaton, PA-C

• Orthodontics and Dentofacial Orthopedics Dentistry in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.