Eagan Orthodontics PC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

13440 Issued in MI

Legal business name

EAGAN ORTHODONTICS PC

Practice address

17600 W 12 Mile Road
Suite 4
Southfield, MI 48076-1910

Phone

(248) 569-8770

Fax

(248) 569-2476

NPI assigned

Jan 30, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Joy Victor Eagan, DDS

Title

Owner

Phone

(248) 569-8770

Specialties & licenses 1

Addresses

Other names 1

• Eagan Family Dentistry Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jay Victor Eagan, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Southfield, MI
  • NPI 1386854891
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194861765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17600 W 12 MILE ROAD",
            "address_2": "SUITE 4",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480761910",
            "telephone_number": "248-569-8770",
            "fax_number": "248-569-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17600 W 12 MILE ROAD",
            "address_2": "SUITE 4",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480761910",
            "telephone_number": "248-569-8770",
            "fax_number": "248-569-2476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGAN ORTHODONTICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EAGAN",
        "authorized_official_first_name": "JOY",
        "authorized_official_middle_name": "VICTOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-569-8770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MI",
            "license": "13440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagan Family Dentistry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Samantha Marie Eaddy, RN
• Jay Victor Eagan, DDS
• Christopher Eaglen, D.C.
• Ear Nose and Throat Consultants PC (Quality Hearing Aid Center)
• Earl Bogrow DDS PC
• Alice M Early, NP

• Orthodontics and Dentofacial Orthopedics Dentistry in Southfield, MI
• Providers in Southfield, MI by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.