Chad T Eardley, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

6743853-9921 Issued in UT

Practice address

CMR 427
Box 1120
Apo, AE 09630

Phone

(123) 456-7890

NPI assigned

Apr 1, 2010

Last updated

Jul 17, 2023By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chad T Eardley DMD PLLC

  • Pediatric Dentistry
  • Pleasant View, UT
  • NPI 1619657186
  NPD Authorized official

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

{
    "created_epoch": "1270080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1285959353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 S KNIGHTS WAY",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840376901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "MIL",
            "address_1": "CMR 427",
            "address_2": "BOX 1120",
            "city": "APO",
            "state": "AE",
            "postal_code": "09630",
            "telephone_number": "123-456-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARDLEY",
        "first_name": "CHAD",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-01",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "UT",
            "license": "6743853-9921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.