NPIMap

Organization Active NPI

Eaglin Family Dentistry, LLC

  • General Practice Dentistry
  • Jonesboro, GA
National Provider Identifier
1033380605
Registry record updated Mar 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
BE9572581 Issued in GA
Legal business name
EAGLIN FAMILY DENTISTRY, LLC
Practice address
248 Arrowhead Blvd
Jonesboro, GA 30236-1106
Phone
(770) 471-2333
NPI assigned
Mar 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2008

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

Authorized official

Name
Dr. Jason S Eaglin, DDSNPI 1053329136
Title
Dentist/Owner
Phone
(770) 471-2333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X BE9572581 GA Primary

Addresses

Primary practice location

248 Arrowhead Blvd
Jonesboro, GA 30236-1106

Mailing address

248 Arrowhead Blvd
Jonesboro, GA 30236-1106
Phone (770) 471-2333

Other identifiers 3

IdentifierTypeStateIssuer
182357OtherGADORAL
102167OtherGAAVESIS
777472578BMedicaidGA

National Provider Directory

National Provider Directory

Locations

248 Arrowhead Blvd
Jonesboro, GA 30236
Phone (770) 471-2333

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1206057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206057600000",
    "number": "1033380605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 ARROWHEAD BLVD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361106",
            "telephone_number": "770-471-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 ARROWHEAD BLVD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361106",
            "telephone_number": "770-471-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLIN FAMILY DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-21",
        "last_updated": "2008-03-21",
        "status": "A",
        "authorized_official_last_name": "EAGLIN",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "770-471-2333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "BE9572581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "182357",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "102167",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "777472578B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.