Active NPI
E Charles Eckstein, DMD
- Dentist
- Fort Wayne, IN
National Provider Identifier
1144353467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12010964A
- Practice address
- 435 W Coliseum Blvd
Fort Wayne, IN 46805-1010 - Phone
- (260) 969-5367
- NPI assigned
- Mar 14, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 02985501 | NY | |
| Dentist | 122300000X | 9282 | NJ | |
| Dentist | 122300000X | DS035365 | PA | |
| Dentist | 122300000X | 016 0002137 | VT | |
| Dentist | 122300000X | 12010964A | IN | Primary |
Addresses
Primary practice location
435 W Coliseum Blvd
Fort Wayne, IN 46805-1010
Mailing address
PO Box 316
Williamsville, NY 14231
Phone (716) 204-4999
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 |
|---|---|---|---|
| 12010964A | IN | MD | Dentist |
| 9282 | NJ | MD | Dentist |
| 02985501 | NY | MD | Dentist |
| DS035365 | PA | MD | Dentist |
| 016 0002137 | VT | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allcare Dental & Dentures of in PC | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- Fort Wayne, IN
- NPI 1205007515
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225238400000",
"number": "1144353467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 316",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "14231",
"telephone_number": "716-204-4999",
"fax_number": "716-623-2963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "435 W COLISEUM BLVD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468051010",
"telephone_number": "260-969-5367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ECKSTEIN",
"first_name": "E",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-14",
"last_updated": "2008-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "02985501",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "9282",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS035365",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VT",
"license": "016 0002137",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12010964A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.