Active NPI
Kyle S. Eberhardt, D.D.S.
- Dentist
- Akron, OH
National Provider Identifier
1730378084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30-022605
- Practice address
- 1655 W Market St
Ste. 540
Akron, OH 44313-7004 - Phone
- (330) 836-5585
- NPI assigned
- Oct 22, 2007
- 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 | 30-022605 | OH | Primary |
Addresses
Primary practice location
1655 W Market St
Ste. 540
Akron, OH 44313-7004
Mailing address
1655 W Market St
Ste. 540
Akron, OH 44313-7004
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
- Opted out of Medicare
- Yes, effective Mar 17, 2016 through Mar 17, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30-022605 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722988800000",
"number": "1730378084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1655 W MARKET ST",
"address_2": "STE. 540",
"city": "AKRON",
"state": "OH",
"postal_code": "443137004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1655 W MARKET ST",
"address_2": "STE. 540",
"city": "AKRON",
"state": "OH",
"postal_code": "443137004",
"telephone_number": "330-836-5585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBERHARDT",
"first_name": "KYLE",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-22",
"last_updated": "2024-08-07",
"certification_date": "2024-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30-022605",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Akron, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.