Eagle Family Dental Center

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00006048 Issued in WA

Legal business name

EAGLE FAMILY DENTAL CENTER

Practice address

20210 77TH Ave NE
Arlington, WA 98223-4602

Phone

(360) 435-2151

Fax

(360) 435-7845

NPI assigned

Aug 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey D. Huleatt, D.D.S.

Title

Doctor/Owner

Phone

(360) 435-2151

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801806898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20210 77TH AVE NE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982234602",
            "telephone_number": "360-435-2151",
            "fax_number": "360-435-7845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20210 77TH AVE NE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982234602",
            "telephone_number": "360-435-2151",
            "fax_number": "360-435-7845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE FAMILY DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HULEATT",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "360-435-2151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00006048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF WASH LICENSE",
            "identifier": "DE00007379",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF WASHINGTON LICEN",
            "identifier": "DE00006048",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryce Kelly Duskin, D,D,S
• Celia Duty
• DW Han DMD PLLC. (Arlington Family Dentistry)
• John T. Dykstra, D.D.S., P.L.L.C
• Jessie Jiyeon Dziduch, FNP-C
• Eberhardt Vision Center, Inc (Arlington Vision Center)
• Jennifer Wendt Edwards, MA,LMHC
• Sarah Eickhoff
• Edward W Eissmann, MD
• Ekapoj Thongin III, DMD, PLLC (8 to 8 DENTAL SMOKEY POINT)

• General Practice Dentistry in Arlington, WA
• Providers in Arlington, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.