Dr. Susan P Eddleman

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

14169 Issued in MO

Legal business name

DR. SUSAN P EDDLEMAN

Practice address

204 S Main St
Rock Port, MO 64482-1532

Phone

(660) 744-5391

Fax

(660) 744-5301

NPI assigned

Jan 20, 2010

Last updated

Jan 20, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Susan Eddleman, DDSNPI 1184610909

Title

Dentist

Phone

(660) 744-5391

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan Pancoast Eddleman, D.D.S.

  • General Practice Dentistry
  • Rock Port, MO
  • NPI 1184610909
  NPD (past) Authorized official

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263945600000",
    "number": "1518298231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 S MAIN ST",
            "address_2": "PO BOX 282",
            "city": "ROCK PORT",
            "state": "MO",
            "postal_code": "644821532",
            "telephone_number": "660-744-5391",
            "fax_number": "660-744-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 S MAIN ST",
            "city": "ROCK PORT",
            "state": "MO",
            "postal_code": "644821532",
            "telephone_number": "660-744-5391",
            "fax_number": "660-744-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. SUSAN P EDDLEMAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-20",
        "last_updated": "2010-01-20",
        "status": "A",
        "authorized_official_last_name": "EDDLEMAN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "660-744-5391",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MO",
            "license": "14169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bartholomew Drug Inc (Stoner Drug)
• Joanna Burke, PNP
• Richard Aron Burke, M.D.
• Community Hospital Association (Community Hospital-Fairfax)
• Pamala D Davis, RNCS,FNP
• Susan Pancoast Eddleman, D.D.S.
• Jennifer L Long-Kelly, LPC
• Janell Ann Moore, LPC, LMHP
• Northwest Missouri Industries, Inc.
• Misty Marie Olberding, D.C.

• Dental Clinic/Center in Rock Port, MO
• Providers in Rock Port, MO by specialty
• Dental Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; 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.