Zackery Ethan Eades, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

0006649-C1 Issued in AL

Practice address

1803 Station Dr Ste a
Prattville, AL 36066-5671

Phone

(334) 361-9880

NPI assigned

Jul 29, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Dentist

Education

University of Alabama School of Dentistry, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Autauga Station Dental

  • Dental Clinic/Center
  • Prattville, AL
  • NPI 1275429383
  Medicare reassignment NPD Authorized official
• Oak Park Dental LLC

  • General Practice Dentistry
  • Troy, AL
  • NPI 1134774219
  NPD
• Autauga Station Dental, P.C.

  • General Practice Dentistry
  • Prattville, AL
  • NPI 1235471426
  NPD (past)

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751673600000",
    "number": "1255985289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 STATION DR STE A",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360665671",
            "telephone_number": "334-361-9880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 STATION DR STE A",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360665671",
            "telephone_number": "334-361-9880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "98 Oak Park Dr",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "AL",
            "postal_code": "360793085",
            "country_code": "US",
            "telephone_number": "205-913-1969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EADES",
        "first_name": "ZACKERY",
        "middle_name": "ETHAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-29",
        "last_updated": "2025-07-05",
        "certification_date": "2025-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "0006649-C1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Bethany Duncan
• Madison Easterling
• Ann A Eckel, PT
• Melvin J Ehrlich, BPHARM
• George Nicholas Eischens, O.D.
• Elitecare Healthservices LLC

• Dentist in Prattville, AL
• Providers in Prattville, AL by specialty
• Dentist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.