Keagan A Eckland, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00011044 Issued in WA

Practice address

17330 135TH Ave NE
Suite 1-a
Woodinville, WA 98072-8522

Phone

(425) 481-0755

Fax

(425) 487-1578

NPI assigned

Jul 24, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 13, 2012 through Jul 13, 2028

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.

• Eckland PLLC

  • General Practice Dentistry
  • Woodinville, WA
  • NPI 1538422712
  NPD (past)

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276128000000",
    "number": "1164622320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17330 135TH AVE NE",
            "address_2": "SUITE 1-A",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980728522",
            "telephone_number": "425-481-0755",
            "fax_number": "425-487-1578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17330 135TH AVE NE",
            "address_2": "SUITE 1-A",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980728522",
            "telephone_number": "425-481-0755",
            "fax_number": "425-487-1578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKLAND",
        "first_name": "KEAGAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-24",
        "last_updated": "2010-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00011044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eagle Eye Vision Care PS
• Eric Eagleson
• Eastside Psychological Associates PLLC
• Eckland PLLC
• Daryl Bruce Eckland, D.D.S.
• Shannon Edmonds
• Sally Saran Edwards, MD
• Sarah Eisert, SLP
• Ekl Heatlh, LLC
• Elevate Physical Rehabilitation Group PLLC

• General Practice Dentistry in Woodinville, WA
• Providers in Woodinville, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.