Ralph Mark Eichstaedt, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN15139 Issued in FL

Practice address

1060 W Busch Blvd
Suite 105
Tampa, FL 33612-7707

Phone

(813) 931-4000

Fax

(813) 935-6532

NPI assigned

Jan 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1168041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760530901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2033 20TH AVENUE PKWY",
            "city": "INDIAN ROCKS BEACH",
            "state": "FL",
            "postal_code": "337852971",
            "telephone_number": "407-405-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 W BUSCH BLVD",
            "address_2": "SUITE 105",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336127707",
            "telephone_number": "813-931-4000",
            "fax_number": "813-935-6532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EICHSTAEDT",
        "first_name": "RALPH",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN15139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert P. Ehrlich, PH.D.
• Rodolfo D Eichberg, M.D.
• Gerry Samantha Eichelberger
• Kathryn Rose Eichenbaum, RN
• Brooke D Eichenlaub
• Ahmed Eid
• Jolene Eid
• Edward A. Eikman, M.D.
• Isabella Nicole Eiland
• Eileen Gustafson LCSW PA

• Oral and Maxillofacial Surgery (Dentist) in Tampa, FL
• Providers in Tampa, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.