Organization Active NPI

Riverbend Endodontics, P.C.

  • Endodontics
  • Bettendorf, IA
National Provider Identifier
1083018840
Registry record updated Oct 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
08284 Issued in IA
Legal business name
RIVERBEND ENDODONTICS, P.C.
Practice address
2550 Middle Road
Suite 101
Bettendorf, IA 52722-3298
Phone
(563) 209-9041
Fax
(563) 209-9042
NPI assigned
Oct 22, 2014
Last updated
Oct 22, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2014

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

Authorized official

Name
Gary Wayne Eggleston, DDS, MSNPI 1912949595
Title
Owner
Phone
(563) 209-9041

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 09095 IA
Endodontics 1223E0200X 08284 IA Primary

Addresses

Primary practice location

2550 Middle Road
Suite 101
Bettendorf, IA 52722-3298

Mailing address

2550 Middle Road
Suite 101
Bettendorf, IA 52722-3298
Phone (563) 209-9041

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413936000000",
    "number": "1083018840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 MIDDLE ROAD",
            "address_2": "SUITE 101",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223298",
            "telephone_number": "563-209-9041",
            "fax_number": "563-209-9042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 MIDDLE ROAD",
            "address_2": "SUITE 101",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223298",
            "telephone_number": "563-209-9041",
            "fax_number": "563-209-9042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERBEND ENDODONTICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-22",
        "last_updated": "2014-10-22",
        "status": "A",
        "authorized_official_last_name": "EGGLESTON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "563-209-9041",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IA",
            "license": "09095",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IA",
            "license": "08284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; 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.