Active NPI
Kevin Timothy Eagan, DDS, MPH
- Dentist
- Warwick, RI
National Provider Identifier
1689244790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 03758
- Practice address
- 222 Jefferson Blvd Ste 100
Warwick, RI 02888-3855 - Phone
- (401) 736-5136
- NPI assigned
- Jun 30, 2021
- Last updated
- Apr 14, 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 03758 | RI | Primary |
Addresses
Primary practice location
222 Jefferson Blvd Ste 100
Warwick, RI 02888-3855
Mailing address
222 Jefferson Blvd Ste 100
Warwick, RI 02888-3855
Phone (401) 736-5136
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 |
|---|---|---|---|
| 03758 | RI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776124800000",
"number": "1689244790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 JEFFERSON BLVD STE 100",
"city": "WARWICK",
"state": "RI",
"postal_code": "028883855",
"telephone_number": "401-736-5136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 JEFFERSON BLVD STE 100",
"city": "WARWICK",
"state": "RI",
"postal_code": "028883855",
"telephone_number": "401-736-5136"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EAGAN",
"first_name": "KEVIN",
"middle_name": "TIMOTHY",
"name_prefix": "Dr.",
"credential": "DDS, MPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-30",
"last_updated": "2026-04-14",
"certification_date": "2026-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "RI",
"license": "03758",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warwick, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.