Individual provider Active NPI

Eric Dyson, HIS

  • Hearing Instrument Specialist
  • Garden Grove, CA
National Provider Identifier
1417354135
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
9562 Issued in CA
Practice address
12062 Valley View St Ste 100
Garden Grove, CA 92845-1738
Phone
(714) 893-6790
Fax
(714) 893-6904
NPI assigned
Nov 24, 2014
Last updated
Mar 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 9562 CA Primary
Hearing Instrument Specialist 237700000X F03563 PA

Addresses

Primary practice location

12062 Valley View St Ste 100
Garden Grove, CA 92845-1738

Mailing address

750 N Commons Dr Ste 200
Aurora, IL 60504-7940
Phone (630) 303-5380

Other practice location 1

879 W 190th St Fl 4
Gardena, CA 90248-4223
Phone (310) 217-4059

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

LicenseStateTypeSpecialty
9562CAMDClinical Social Worker
F03563PAMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Connect Hearing, Inc. Hearing Instrument Specialist CurrentSince Mar 16, 2021 Accepting new patients
Connect Hearing Inc Hearing Instrument Specialist PastSince Mar 16, 2021 Accepting new patients
Connect Hearing, Inc. Hearing Instrument Specialist Past Accepting new patients

Locations

12062 Valley View St
Ste 100
Garden Grove, CA 92845
Phone (714) 893-6790

750 N Commons Dr
Ste 200
Aurora, IL 60504

215 Shuman Blvd
Ste 401
Naperville, IL 60563
Phone (331) 229-8279

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": "1416787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1417354135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N COMMONS DR STE 200",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047940",
            "telephone_number": "630-303-5380",
            "fax_number": "630-303-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12062 VALLEY VIEW ST STE 100",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928451738",
            "telephone_number": "714-893-6790",
            "fax_number": "714-893-6904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "879 W 190th St Fl 4",
            "address_purpose": "LOCATION",
            "city": "Gardena",
            "state": "CA",
            "postal_code": "902484223",
            "country_code": "US",
            "telephone_number": "310-217-4059",
            "fax_number": "310-217-4065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYSON",
        "first_name": "ERIC",
        "credential": "HIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-24",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "CA",
            "license": "9562",
            "primary": true
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "PA",
            "license": "F03563",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; 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.