Justin A Ebersole, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

60484 Issued in KS

Practice address

1701 Washington Ave
Parsons, KS 67357-3204

Phone

(620) 421-0980

NPI assigned

Jun 4, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Parsons Dental Care LLC

  • General Practice Dentistry
  • Parsons, KS
  • NPI 1134358740
  NPD (past) Authorized official
• Dr. Joe Wommack, P.a.

  • General Practice Dentistry
  • Parsons, KS
  • NPI 1558586404
  NPD (past)

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487856357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 DEER TRAIL ST",
            "city": "PARSONS",
            "state": "KS",
            "postal_code": "673572122",
            "telephone_number": "620-421-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 WASHINGTON AVE",
            "city": "PARSONS",
            "state": "KS",
            "postal_code": "673573204",
            "telephone_number": "620-421-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERSOLE",
        "first_name": "JUSTIN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "60484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KS DENTAL LICENSE",
            "identifier": "60484",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Lynn Huffman Driskel, FNP-BC
• Amy Kathleen Duensing, RN
• Dylan Wayne Dyke, DC
• Isaac E Bussinger
• Emily Eagle
• Chris J Edwards
• Beth Ann Engels, LMSW
• Rhonda Renee Etter
• Eyecare Associates of Parsons, LLC
• Tercya Vanessa Ferreira Jarman, APRN FNP-C

• General Practice Dentistry in Parsons, KS
• Providers in Parsons, KS by specialty
• General Practice Dentistry in Kansas

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.