Eric Egan, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

2023014638 Issued in MO

Practice address

15817 Fountain Plaza Dr
Chesterfield, MO 63017-7468

Phone

(636) 220-1104

NPI assigned

Jun 25, 2020

Last updated

Apr 11, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Missouri Dental Professionals, Richard Straus, DMD, PC

  dba Family Dentistry of Arnold

  • General Practice Dentistry
  • Arnold, MO
  • NPI 1720208044
  NPD (past)
• Creating Smiles LLC

  dba Creating Smiles Family and Cosmetic Dentistry

  • Durable Medical Equipment & Medical Supplies
  • Collinsville, IL
  • NPI 1083152243
  NPD (past)
• Dental Professionals of Illinois, P.C.

  dba Creating Smiles Cosmetic and Family Dentistry

  • Dentist
  • Collinsville, IL
  • NPI 1235876814
  NPD (past)

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

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1033736087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2476 GEORGETOWN CIR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605036718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15817 FOUNTAIN PLAZA DR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630177468",
            "telephone_number": "636-220-1104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 NE Glen Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616370001",
            "country_code": "US",
            "telephone_number": "309-624-2411",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2440 S Brentwood Blvd",
            "address_purpose": "LOCATION",
            "city": "Brentwood",
            "state": "MO",
            "postal_code": "631442320",
            "country_code": "US",
            "telephone_number": "314-696-1544",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3608 Jeffco Blvd",
            "address_purpose": "LOCATION",
            "city": "Arnold",
            "state": "MO",
            "postal_code": "630103920",
            "country_code": "US",
            "telephone_number": "636-464-1008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 United Dr Ste 150",
            "address_purpose": "LOCATION",
            "city": "Collinsville",
            "state": "IL",
            "postal_code": "622347439",
            "country_code": "US",
            "telephone_number": "618-345-7676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EGAN",
        "first_name": "ERIC",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-25",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.032714",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2023014638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "OSF",
            "affiliation": "N",
            "address_1": "530 NE Glen Oak Ave",
            "city": "Peoria",
            "state": "IL",
            "country_code": "US",
            "postal_code": "616370001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emily Edwards, BCBA
• Jason Matthew Edwards, M.D. PH.D.
• Kimberly Edwards
• Phyllis A Edwards, CRNA
• Toni Edwards, FNP-C
• Ehmd 2, LLC
• Kari Ann Ehringer, RPH, PHARMD
• Madison Anne Eisenbraun
• Rhody D Eisenstein, MD
• Madison Ekern, BCBA

• Dentist in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.