Carl W Eilers Jr., DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS7751 Issued in TN

Practice address

508 Princeton Rd
Suite 204
Johnson City, TN 37601-2060

Phone

(423) 915-1072

NPI assigned

Aug 9, 2005

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

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• L Alan Bacon DDS PC & John Collins DDS PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Johnson City, TN
  • NPI 1518969229
  NPD (past)
• L Alan Bacon DDS PC & John Collins DDS PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Bristol, TN
  • NPI 1609878388
  NPD (past)

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1295736569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 PRINCETON RD",
            "address_2": "SUITE 204",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 PRINCETON RD",
            "address_2": "SUITE 204",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012060",
            "telephone_number": "423-915-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EILERS",
        "first_name": "CARL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "DS7751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORGANIZATION NPI",
            "identifier": "1609878388",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "3726194",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORGANIZATION NPI NUMBER",
            "identifier": "1518969229",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORGANIZATION NPI",
            "identifier": "1972504389",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Morgan Patrick Edwards, PA
• Tammy Edwards, RN
• Toni Lee Edwards, BSN
• Amira Eftaiha, MBBS
• Lorna K Ehrenfried, M.D.
• Kristy Strong Eisenzopf, M.ED., CCC-SLP
• Tracy Eiswert, CMSW
• Marcheta Raquel Ejiwumi, LMSW
• Janet Michelle Ekstrom, M.S., CCC-SLP
• Hana El Ado Mikdachi, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; 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.