Active NPI
Harold R Eberhardt, DDS
- General Practice Dentistry
- Inver Grove, MN
National Provider Identifier
1245341098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7298
- Practice address
- 5625 Cenex Dr
Inver Grove, MN 55077 - Phone
- (651) 552-1752
- Fax
- (651) 552-2682
- NPI assigned
- Aug 31, 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7298 | MN | Primary |
Addresses
Primary practice location
5625 Cenex Dr
Inver Grove, MN 55077
Mailing address
Mall Code 21113a
PO Box 1309
Minneapolis, MN 55440-1309
Phone (952) 883-5151
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 |
|---|---|---|---|
| 7298 | MN | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245341098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MALL CODE 21113A",
"address_2": "PO BOX 1309",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554401309",
"telephone_number": "952-883-5151",
"fax_number": "952-883-5160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5625 CENEX DR",
"city": "INVER GROVE",
"state": "MN",
"postal_code": "55077",
"telephone_number": "651-552-1752",
"fax_number": "651-552-2682"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBERHARDT",
"first_name": "HAROLD",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "7298",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Inver Grove, MN
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.