NPIMap

Organization Active NPI

Eggleston Family Dentistry PC

Doing business as esmiles

  • General Practice Dentistry
  • Kentwood, MI
National Provider Identifier
1245283340
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901015986 Issued in MI
Legal business name
EGGLESTON FAMILY DENTISTRY PC
Doing business as
esmiles
Practice address
4649 N Breton CT SE
#B
Kentwood, MI 49508-5211
Phone
(616) 682-0147
NPI assigned
May 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Edward Harrison Eggleston, DDSNPI 1508812348
Title
President
Phone
(616) 682-0147

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2901015986 MI Primary

Addresses

Primary practice location

4649 N Breton CT SE
#B
Kentwood, MI 49508-5211

Mailing address

4649 N Breton CT SE
#B
Kentwood, MI 49508-5211
Phone (616) 682-0147

Other names 1

  • esmiles Doing business as

National Provider Directory

National Provider Directory

Locations

4649 N Breton Ct SE
Ste B
Kentwood, MI 49508
Phone (616) 682-0147

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245283340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4649 N BRETON CT SE",
            "address_2": "#B",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495085211",
            "telephone_number": "616-682-0147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4649 N BRETON CT SE",
            "address_2": "#B",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495085211",
            "telephone_number": "616-682-0147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EGGLESTON FAMILY DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EGGLESTON",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "HARRISON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-682-0147",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901015986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "esmiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kentwood, MI

Sources for this page

  • 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.