Individual provider Active NPI

Michael E Eeds, DDS

  • General Practice Dentistry
  • Corsicana, TX
National Provider Identifier
1346468329
Registry record updated Aug 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10586 Issued in TX
Practice address
1661 W 2ND Ave
Corsicana, TX 75110-4107
Phone
(903) 872-1661
Fax
(903) 872-5961
NPI assigned
Apr 23, 2007
Last updated
Aug 13, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2012

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 10586 TX Primary

Addresses

Primary practice location

1661 W 2ND Ave
Corsicana, TX 75110-4107

Mailing address

1661 W 2ND Ave
Corsicana, TX 75110-4107
Phone (903) 872-1661

Other identifiers 1

IdentifierTypeStateIssuer
009402103MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150910002444 TX Order and Referring Only - DentistPractitioner - Dentist 6204141781

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
10586TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
1661 W 2ND Corsicana Services, LLC General Practice Current Accepting new patients

Locations

1661 W 2nd Ave
Corsicana, TX 75110
Phone (903) 872-1661

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344816000000",
    "number": "1346468329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 W 2ND AVE",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751104107",
            "telephone_number": "903-872-1661",
            "fax_number": "903-872-5961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 W 2ND AVE",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751104107",
            "telephone_number": "903-872-1661",
            "fax_number": "903-872-5961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EEDS",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2012-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "10586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009402103",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corsicana, TX

Sources for this page

Verify at the official NPI Registry.