Individual provider Active NPI

John T Eilers, D.M.D.

  • General Practice Dentistry
  • Portland, OR
National Provider Identifier
1295849909
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4617 Issued in OR
Practice address
5018 E Burnside St
Portland, OR 97215-1151
Phone
(503) 231-9995
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4617 OR Primary

Addresses

Primary practice location

5018 E Burnside St
Portland, OR 97215-1151

Mailing address

5018 E Burnside St
Portland, OR 97215-1151
Phone (503) 231-9995

Other names 1

  • Dr. J T Eilers Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20160330000883 OR Order and Referring Only - DentistPractitioner - Dentist 3678870045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4617ORMDOrthopedic Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295849909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5018 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151151",
            "telephone_number": "503-231-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5018 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151151",
            "telephone_number": "503-231-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EILERS",
        "first_name": "JOHN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "4617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "J",
            "last_name": "EILERS",
            "middle_name": "T",
            "prefix": "DR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.