Active NPI
Merlin Dale Eaton, D.D.S
- Dentist
- Warsaw, MO
National Provider Identifier
1184700742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 012695
- Practice address
- 1631 Commercial St
Warsaw, MO 65355-3060 - Phone
- (660) 438-5139
- Fax
- (660) 438-8649
- NPI assigned
- Oct 27, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 012695 | MO | Primary |
Addresses
Primary practice location
1631 Commercial St
Warsaw, MO 65355-3060
Mailing address
1631 Commercial St
Warsaw, MO 65355-3060
Phone (660) 438-5139
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 |
|---|---|---|---|
| 012695 | MO | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Truman Lake Dental, LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Warsaw, MO
- NPI 1902227036
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184700742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1631 COMMERCIAL ST",
"city": "WARSAW",
"state": "MO",
"postal_code": "653553060",
"telephone_number": "660-438-5139",
"fax_number": "660-438-8649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1631 COMMERCIAL ST",
"city": "WARSAW",
"state": "MO",
"postal_code": "653553060",
"telephone_number": "660-438-5139",
"fax_number": "660-438-8649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EATON",
"first_name": "MERLIN",
"middle_name": "DALE",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "012695",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warsaw, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.