Individual provider Active NPI

Emily Ann Eisenberger, DDS

  • Dentist
  • Hutchinson, MN
National Provider Identifier
1639912470
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D15119 Issued in MN
Practice address
10 Hassan St NE
Hutchinson, MN 55350-1800
Phone
(320) 587-2726
NPI assigned
Jun 18, 2024
Last updated
Jun 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D15119 MN Primary

Addresses

Primary practice location

10 Hassan St NE
Hutchinson, MN 55350-1800

Mailing address

4141 Rivers Edge Pkwy Apt 305
Council Bluffs, IA 51501-5203
Phone (630) 877-0451

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
D15119MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Dental PLLC Dentist PastSince Jun 23, 2024 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": "1718668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1639912470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 RIVERS EDGE PKWY APT 305",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515015203",
            "telephone_number": "630-877-0451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 HASSAN ST NE",
            "city": "HUTCHINSON",
            "state": "MN",
            "postal_code": "553501800",
            "telephone_number": "320-587-2726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBERGER",
        "first_name": "EMILY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-06-18",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D15119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hutchinson, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.