Individual provider Active NPI

Daniel Britton Eaddy, D.D.S.

  • General Practice Dentistry
  • Austin, TX
National Provider Identifier
1215310420
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
31020 Issued in TX
Practice address
3502 Wild Cherry Drive
BLDG. 11
Austin, TX 78738
Phone
(512) 263-4252
Fax
(512) 263-1568
NPI assigned
Jul 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 31020 TX Primary

Addresses

Primary practice location

3502 Wild Cherry Drive
BLDG. 11
Austin, TX 78738

Mailing address

3502 Wild Cherry Drive
BLDG. 11
Austin, TX 78738
Phone (512) 263-4252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170608001043 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8426326885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31020TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Eaddy Dentistry PA 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.

NPI Registry JSON

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1215310420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 WILD CHERRY DRIVE",
            "address_2": "BLDG. 11",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78738",
            "telephone_number": "512-263-4252",
            "fax_number": "512-263-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 WILD CHERRY DRIVE",
            "address_2": "BLDG. 11",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78738",
            "telephone_number": "512-263-4252",
            "fax_number": "512-263-1568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EADDY",
        "first_name": "DANIEL",
        "middle_name": "BRITTON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-07",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "31020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.