Individual provider Active NPI

Eric Deubler Hoverstad, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Raleigh, NC
National Provider Identifier
1720399017
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
8934 Issued in NC
Practice address
3809 Computer Dr Ste 101
Raleigh, NC 27609-6518
Phone
(919) 298-2820
Fax
(919) 844-2856
NPI assigned
Jul 1, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 8934 NC Primary

Addresses

Primary practice location

3809 Computer Dr Ste 101
Raleigh, NC 27609-6518

Mailing address

3809 Computer Dr Ste 101
Raleigh, NC 27609-6518
Phone (919) 247-8404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Oct 14, 2016 through Oct 14, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8934NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eric D. Hoverstad, DDS, PLLC Oral and Maxillofacial Surgery Current Accepting new patients
Eric D. Hoverstad, DDS PLLC III Oral and Maxillofacial Surgery Current Accepting new patients
Eric D. Hoverstad DDS PLLC II PastSince Nov 12, 2023 Accepting new patients
Gene R. Glover, DDS, PA Oral and Maxillofacial Surgery Past Accepting new patients
Reebye Park & Richman DDS PLC Oral and Maxillofacial Surgery Past Accepting new patients

Locations

3809 Computer Dr
Ste 101
Raleigh, NC 27609
Phone (919) 298-2820

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1720399017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3809 COMPUTER DR STE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096518",
            "telephone_number": "919-247-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3809 COMPUTER DR STE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096518",
            "telephone_number": "919-298-2820",
            "fax_number": "919-844-2856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOVERSTAD",
        "first_name": "ERIC",
        "middle_name": "DEUBLER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-01",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "8934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.