Active NPI
Jason Willis Eaton, DDS
- Dentist
- Layton, UT
National Provider Identifier
1205846458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4990217-9923
- Practice address
- 1916 N. 700 W.
Suite 100
Layton, UT 84041 - Phone
- (801) 525-2200
- Fax
- (801) 525-8806
- NPI assigned
- Aug 9, 2006
- Last updated
- Jul 8, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4990217-9923 | UT | Primary |
Addresses
Primary practice location
1916 N. 700 W.
Suite 100
Layton, UT 84041
Mailing address
1916 N. 700 W.
Suite 100
Layton, UT 84041
Phone (801) 525-2200
Medicare participation
Medicare enrollment files- 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
- Opted out of Medicare
- Previously, effective Sep 21, 2020 through Sep 21, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4990217-9923 | UT | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwestern University | Past | Accepting new patients | |
| Idaho State University | Past | Accepting new patients | |
| Idaho State University | Dentist | Past | Accepting new patients |
Organizations & group practices 3
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.
-
dba Pocatello Family Dentistry
- General Practice Dentistry
- Pocatello, ID
- NPI 1851516256
-
- Dentist
- Boise, ID
- NPI 1912110164
-
dba Midwestern University Dental Institute
- Dental Clinic/Center
- Glendale, AZ
- NPI 1164744009
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205846458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1916 N. 700 W.",
"address_2": "SUITE 100",
"city": "LAYTON",
"state": "UT",
"postal_code": "84041",
"telephone_number": "801-525-2200",
"fax_number": "801-525-8806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1916 N. 700 W.",
"address_2": "SUITE 100",
"city": "LAYTON",
"state": "UT",
"postal_code": "84041",
"telephone_number": "801-525-2200",
"fax_number": "801-525-8806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EATON",
"first_name": "JASON",
"middle_name": "WILLIS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "4990217-9923",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Layton, UT
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.
- 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.