Gwen C Eaker, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

25-1852300 Issued in PA

Practice address

172 Creekside Park Rd Ste 102
Spring Branch, TX 78070-6221

Phone

(830) 438-2121

Fax

(830) 438-5191

NPI assigned

Jan 4, 2007

Last updated

Dec 19, 2013By the provider in NPPES

Sex

Female

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 OH

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

State licenses

Practice roles

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

• TM2 Dental ,PLLC

  • Dental Clinic/Center
  • Spring Branch, TX
  • NPI 1104428622
  NPD (past)

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1760539852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 CREEKSIDE PARK SUITE #102",
            "city": "SPRING BRANCH",
            "state": "TX",
            "postal_code": "78070",
            "telephone_number": "830-438-2121",
            "fax_number": "830-438-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 CREEKSIDE PARK RD STE 102",
            "city": "SPRING BRANCH",
            "state": "TX",
            "postal_code": "780706221",
            "telephone_number": "830-438-2121",
            "fax_number": "830-438-5191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAKER",
        "first_name": "GWEN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "25-1852300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Katharine Denicolo, LPC
• Dermrepublic PLLC
• Mary Disbrow, LMFT-ASSOCIATE
• Michelle Douglas, MA, LPC
• Garrett Dyer, FNP-C
• Brittany Ann Edwards
• Reneau Lynn Elsworth, PT
• Jaymi Lynn Engelhardt
• Julian Cesar Espinoza, PHARMD
• Excel Care

• General Practice Dentistry in Spring Branch, TX
• Providers in Spring Branch, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; 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.