Derek J Eaton DDS PLLC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

9225 Issued in NC

Legal business name

DEREK J EATON DDS PLLC

Doing business as

Carolina Oral & Maxillofacial Surgery

Practice address

660 Summit Crossing PL
Suite 303
Gastonia, NC 28054-2104

Phone

(704) 865-0081

Fax

(704) 865-6004

NPI assigned

Nov 8, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Derek James Eaton, D.D.S.NPI 1477649432

Title

Owner

Phone

(704) 865-0081

Specialties & licenses 1

Addresses

Other names 1

• Carolina Oral & Maxillofacial Surgery Doing business as

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.

• Derek J Eaton, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Gastonia, NC
  • NPI 1477649432
  Authorized official Same address or phone

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

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346112000000",
    "number": "1639456486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 SUMMIT CROSSING PL",
            "address_2": "SUITE 303",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542104",
            "telephone_number": "704-865-0081",
            "fax_number": "704-865-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 SUMMIT CROSSING PL",
            "address_2": "SUITE 303",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542104",
            "telephone_number": "704-865-0081",
            "fax_number": "704-865-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEREK J EATON DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-08",
        "last_updated": "2012-08-28",
        "status": "A",
        "authorized_official_last_name": "EATON",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-865-0081",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "9225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina Oral & Maxillofacial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Eldridge Delozier, MSN, PMHNP-BC
• Delta Healthcare Management (Heritage Oaks Assisted Living)
• Philip Joseph Deluca, LCSW
• Pauline Demonico, LCAS, CCS
• Julie Witcher Depalma, MD
• Jonathan Labayo Desamero, FNP
• James Desart, LPC-A
• Heidi Carmel Descalzi, FNP
• Destiny & Miracle LLC
• Haley Noelle Devoe, CRNA

• Oral and Maxillofacial Surgery Clinic/Center in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Oral and Maxillofacial Surgery Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.