Active NPI
Theron Davis Eichenberger, DDS
- Endodontics
- Redmond, WA
National Provider Identifier
1356547236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DE00010007
- Practice address
- 8575 164TH Ave NE
Suite 301
Redmond, WA 98052-3679 - Phone
- (425) 882-3033
- Fax
- (425) 882-2436
- NPI assigned
- Jun 26, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DE00010007 | WA | Primary |
Addresses
Primary practice location
8575 164TH Ave NE
Suite 301
Redmond, WA 98052-3679
Mailing address
224 7TH Ave W
Kirkland, WA 98033-5321
Phone (770) 295-8153
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE00010007 | WA | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dkeidek, Fernyhough, Gile, Hagel, Nov & Quickstad PLLC | Endodontics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Endodontics
- Redmond, WA
- NPI 1245188770
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356547236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 7TH AVE W",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980335321",
"telephone_number": "770-295-8153",
"fax_number": "425-882-2436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8575 164TH AVE NE",
"address_2": "SUITE 301",
"city": "REDMOND",
"state": "WA",
"postal_code": "980523679",
"telephone_number": "425-882-3033",
"fax_number": "425-882-2436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EICHENBERGER",
"first_name": "THERON",
"middle_name": "DAVIS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "WA",
"license": "DE00010007",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redmond, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.