Edmund E Eaves

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

037637 Issued in NY

Practice address

660 Liberty St
Penn Yan, NY 14527-1035

Phone

(315) 536-3341

Fax

(315) 536-7465

NPI assigned

Feb 19, 2007

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

Other identifiers 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 and National Provider Directory roles.

• Eaves Family Dental Group

  • Dentist
  • Penn Yan, NY
  • NPI 1649687013
  NPD (past) Authorized official
• Edmund E & Marilyn Y Eaves PTR

  • General Practice Dentistry
  • Penn Yan, NY
  • NPI 1538203633
  NPD (past) Authorized official

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235001600000",
    "number": "1104960475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 LIBERTY ST",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271035",
            "telephone_number": "315-536-3341",
            "fax_number": "315-536-7465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 LIBERTY ST",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271035",
            "telephone_number": "315-536-3341",
            "fax_number": "315-536-7465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAVES",
        "first_name": "EDMUND",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2009-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "037637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00781282",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vicki June Dornberger, MA SLP
• Taryn Price Draxler, M.D.
• Mary D. Driesch, MD
• Danielle Dunne, LPC/LMHC
• Eaves Family Dental Group
• Marilyn Eaves, DDS
• Edmund E & Marilyn Y Eaves PTR
• Caitlyn Eggleston
• Laurie A Ellis, LCSW
• Arthur Equinozzi II, M.D.

• General Practice Dentistry in Penn Yan, NY
• Providers in Penn Yan, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2009; 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.