Active NPI
Jeffrey Robert Eadie, DDS
- General Practice Dentistry
- Mayfield Village, OH
National Provider Identifier
1760588289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 15909
- Practice address
- 865 Som Center Rd
Mayfield Village, OH 44143 - Phone
- (440) 442-4100
- Fax
- (440) 473-9995
- NPI assigned
- Sep 15, 2006
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 15909 | OH | Primary |
Addresses
Primary practice location
865 Som Center Rd
Mayfield Village, OH 44143
Mailing address
7920 Sugarbush Lane
Gates Mills, OH 44040
Phone (440) 423-0695
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 |
|---|---|---|---|
| 15909 | OH | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Megan K. Ursick DDS, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dental Clinic/Center
- Mayfield Village, OH
- NPI 1548156151
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760588289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7920 SUGARBUSH LANE",
"city": "GATES MILLS",
"state": "OH",
"postal_code": "44040",
"telephone_number": "440-423-0695",
"fax_number": "440-473-9995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "865 SOM CENTER RD",
"city": "MAYFIELD VILLAGE",
"state": "OH",
"postal_code": "44143",
"telephone_number": "440-442-4100",
"fax_number": "440-473-9995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EADIE",
"first_name": "JEFFREY",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "15909",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mayfield Village, OH
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.