NPIMap

Organization Active NPI

Cody Dental Center P.C.

  • General Practice Dentistry
  • Southfield, MI
National Provider Identifier
1255482659
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13102 Issued in MI
Legal business name
CODY DENTAL CENTER P.C.
Practice address
17070 W 12 Mile Rd
Suite C
Southfield, MI 48076-2116
Phone
(248) 395-4700
NPI assigned
Jan 15, 2007
Last updated
Apr 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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

Authorized official

Name
Dr. Karen E. Eggleston, D.D.S.NPI 1770611006
Title
Owner
Phone
(248) 395-4700

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 Dentistry 1223G0001X 13102 MI Primary

Addresses

Primary practice location

17070 W 12 Mile Rd
Suite C
Southfield, MI 48076-2116

Mailing address

17070 W 12 Mile Rd
Suite C
Southfield, MI 48076-2116
Phone (248) 395-4700

Other identifiers 1

IdentifierTypeStateIssuer
J131020OtherMIBLUE CROSS BLUE SHIELD

Other names 1

  • Dr. Karen E. Eggleston Other name

National Provider Directory

National Provider Directory

Locations

17070 W 12 Mile Rd
Ste C
Southfield, MI 48076
Phone (248) 395-4700

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1255482659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17070 W 12 MILE RD",
            "address_2": "SUITE C",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762116",
            "telephone_number": "248-395-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17070 W 12 MILE RD",
            "address_2": "SUITE C",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762116",
            "telephone_number": "248-395-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CODY DENTAL CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-15",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "EGGLESTON",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-395-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "13102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "J131020",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Karen E. Eggleston",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; 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.