Eric Jay Eisen, DDS MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Practice address

710 Robert York Ave Ste a
Deerfield, IL 60015-4343

Phone

(847) 444-0022

Fax

(847) 444-0033

NPI assigned

Feb 4, 2008

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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 and National Provider Directory roles.

• Deerfield Orthodontics PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Deerfield, IL
  • NPI 1477731297
  NPD (past) Authorized official

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202083200000",
    "number": "1043498868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 ROBERT YORK AVE STE A",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154343",
            "telephone_number": "847-444-0022",
            "fax_number": "847-444-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 ROBERT YORK AVE STE A",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154343",
            "telephone_number": "847-444-0022",
            "fax_number": "847-444-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISEN",
        "first_name": "ERIC",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-04",
        "last_updated": "2008-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brent Corbin Edelcup, PHARMD
• Kelsey Egan, MSW, LCSW
• John Henning Egge, PT
• Deborah Terry Ehrlich, MD
• Steven Barry Eiden, O.D.
• Ej Vision, Inc.
• Phillip L. Elbaum, MSW
• Allyson Faith Eleveld
• Luisa Ellenbogen
• Elliecare, Inc

• Orthodontics and Dentofacial Orthopedics Dentistry in Deerfield, IL
• Providers in Deerfield, IL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.