Jillian E Eaves, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

8985 Issued in SC

Practice address

5551 Sunset Blvd Ste B
Lexington, SC 29072-9132

Phone

(803) 399-8829

Fax

(803) 520-0752

NPI assigned

Jul 17, 2017

Sex

Female

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 SC

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

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

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1023531597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5551 SUNSET BLVD STE B",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290729132",
            "telephone_number": "803-399-8829",
            "fax_number": "803-520-0752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5551 SUNSET BLVD STE B",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290729132",
            "telephone_number": "803-399-8829",
            "fax_number": "803-520-0752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAVES",
        "first_name": "JILLIAN",
        "middle_name": "E",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "8985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Lexington, SC
• Providers in Lexington, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.