NPIMap

Organization Active NPI

Michael C. Eubanks D.M.D. P.S.

  • General Practice Dentistry
  • Burlington, WA
National Provider Identifier
1346452463
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6277 Issued in WA
Legal business name
MICHAEL C. EUBANKS D.M.D. P.S.
Practice address
103 East Hazel Avenue
Burlington, WA 98233
Phone
(360) 755-0057
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Michael C EubanksNPI 1871712588
Title
Doctor
Phone
(360) 755-0057

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 DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 6277 WA Primary

Addresses

Primary practice location

103 East Hazel Avenue
Burlington, WA 98233

Mailing address

103 East Hazel Avenue
Burlington, WA 98233
Phone (360) 755-0057

Other identifiers 3

IdentifierTypeStateIssuer
5008743MedicaidWA
76341OtherWADEPT OF LABOR&INDUSTRIES
840810OtherWAUNITED CONCORDIA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346452463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 EAST HAZEL AVENUE",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "98233",
            "telephone_number": "360-755-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 EAST HAZEL AVENUE",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "98233",
            "telephone_number": "360-755-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL C. EUBANKS D.M.D. P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EUBANKS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "360-755-0057",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "6277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5008743",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR&INDUSTRIES",
            "identifier": "76341",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "840810",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.