Active NPI
Edward Harrison Eggleston, DDS
- General Practice Dentistry
- Kentwood, MI
National Provider Identifier
1508812348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2901015986
- Practice address
- 4649 N Breton CT SE
#B
Kentwood, MI 49508-5211 - Phone
- (616) 682-0147
- NPI assigned
- May 25, 2006
- Last updated
- Jul 13, 2026
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901015986 | MI | Primary |
Addresses
Primary practice location
4649 N Breton CT SE
#B
Kentwood, MI 49508-5211
Mailing address
4649 N Breton CT SE
#B
Kentwood, MI 49508-5211
Phone (616) 682-0147
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 |
|---|---|---|---|
| 2901015986 | MI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eggleston Family Dentistry PC | General Practice | 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, 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": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1508812348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4649 N BRETON CT SE",
"address_2": "#B",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "495085211",
"telephone_number": "616-682-0147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4649 N BRETON CT SE",
"address_2": "#B",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "495085211",
"telephone_number": "616-682-0147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EGGLESTON",
"first_name": "EDWARD",
"middle_name": "HARRISON",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-25",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "2901015986",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kentwood, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.