Active NPI
Aundrea Vereen Eady, DMD
- Prosthodontics
- Decatur, GA
National Provider Identifier
1124315965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- DN015060
- Practice address
- 2485 Park Central Blvd Ste 3
Decatur, GA 30035-3903 - Phone
- (770) 593-4976
- NPI assigned
- Jun 30, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | DN015060 | GA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
2485 Park Central Blvd Ste 3
Decatur, GA 30035-3903
Mailing address
2485 Park Central Blvd Ste 3
Decatur, GA 30035-3903
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN015060 | GA | MD | Prosthodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Progressive DG, LLC | Prosthodontics | Current | Accepting new patients |
Locations
2485 Park Central Blvd
Ste 3
Decatur, GA 30035
Phone (770) 593-4976
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586995200000",
"number": "1124315965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2485 PARK CENTRAL BLVD STE 3",
"city": "DECATUR",
"state": "GA",
"postal_code": "300353903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2485 PARK CENTRAL BLVD STE 3",
"city": "DECATUR",
"state": "GA",
"postal_code": "300353903",
"telephone_number": "770-593-4976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EADY",
"first_name": "AUNDREA",
"middle_name": "VEREEN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-30",
"last_updated": "2020-04-16",
"certification_date": "2020-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "GA",
"license": "DN015060",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.