Eastpark Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4943 Issued in WI

Legal business name

EASTPARK DENTAL LLC

Practice address

5100 Eastpark Blvd
Suite 110
Madison, WI 53718-2149

Phone

(608) 222-8232

Fax

(608) 222-8340

NPI assigned

Oct 22, 2009

Last updated

Oct 22, 2009By 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. Karl WeaverNPI 1629157847

Title

Dentist

Phone

(608) 222-8232

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.

• Karl David Weaver, D.D.S.

  • General Practice Dentistry
  • Madison, WI
  • NPI 1629157847
  NPD (past) Authorized official

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

{
    "created_epoch": "1256169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256169600000",
    "number": "1679809974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 EASTPARK BLVD",
            "address_2": "SUITE 110",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537182149",
            "telephone_number": "608-222-8232",
            "fax_number": "608-222-8340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 EASTPARK BLVD",
            "address_2": "SUITE 110",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537182149",
            "telephone_number": "608-222-8232",
            "fax_number": "608-222-8340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTPARK DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-22",
        "last_updated": "2009-10-22",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "KARL",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "608-222-8232",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "4943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Eastman, M.D.
• James Weston Eastman, MSW
• Lauren Eastman
• Sarah Eastman, CF-SLP
• Eastpark Care Services LLC
• Diana Eastridge, NP-FAMILY
• Eating Disorder Support Network
• Eating Disorder Support Network
• Kelsey James Eaton, DO
• Richard B Eaton, PA-C

• General Practice Dentistry in Madison, WI
• Providers in Madison, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2009; 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.