Eagle Dental P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22575 Issued in TX

Legal business name

EAGLE DENTAL P.C.

Practice address

12609 S Gessner Dr
Houston, TX 77071-2803

Phone

(713) 774-6700

Fax

(713) 774-6704

NPI assigned

May 27, 2010

Last updated

Jun 23, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

SUN DENTAL GROUP P.A.As reported in NPPES

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

Authorized official

Name

Dr. Davin E Odia, DDS

Title

Owner

Phone

(832) 790-2223

Specialties & licenses 1

Addresses

Other identifiers 4

Part of

Sun Dental Group

Locations

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

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308787200000",
    "number": "1073832291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12609 S. GESSNER DRIVE",
            "address_2": "STE. F",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770712803",
            "telephone_number": "713-774-6700",
            "fax_number": "713-774-6704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12609 S GESSNER DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770712803",
            "telephone_number": "713-774-6700",
            "fax_number": "713-774-6704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE DENTAL P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUN DENTAL GROUP P.A.",
        "enumeration_date": "2010-05-27",
        "last_updated": "2011-06-23",
        "status": "A",
        "authorized_official_last_name": "ODIA",
        "authorized_official_first_name": "DAVIN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-790-2223",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214288701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190960801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIP",
            "identifier": "B22575-02",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIP",
            "identifier": "B22575-01",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Eady
• Carlon Ann Eagan, SPEECH PATHOLOGIST
• Todd N Eagar, PH.D.
• John Jacob Eager, M.D.
• Antoinette Nicole Eaglan, REGISTERED NURSE
• Eagle E Personal Assistance Service L.L.C.
• Eagle E Personal Assistance Service L.L.C.
• Eagle EMS LLC (Eagle EMS)
• Eagle Eye Center Bellaire LLC
• Eagle-I Behavioral Health Services PLLC

• General Practice Dentistry in Houston, TX
• Providers in Houston, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; 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.