Todd Ivan Eggleston, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

16420 Issued in TX

Practice address

1801 N Lamar Blvd
Suite 102
Austin, TX 78701-1056

Phone

(512) 391-0011

Fax

(512) 391-0031

NPI assigned

Jun 28, 2006

Last updated

Jul 9, 2007By the provider in NPPES

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

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Aug 2, 2017 through Aug 2, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1801823216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 N LAMAR BLVD",
            "address_2": "SUITE 102",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787011056",
            "telephone_number": "512-391-0011",
            "fax_number": "512-391-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N LAMAR BLVD",
            "address_2": "SUITE 102",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787011056",
            "telephone_number": "512-391-0011",
            "fax_number": "512-391-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGGLESTON",
        "first_name": "TODD",
        "middle_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "16420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nora Egeolu
• Sarah Eggers, ACNS-BC
• Althea Eggleston, D.D.S
• John M. Eggleston III, M.D.
• Patricia Eggleston, RD
• Gianni Eguakun, LPC
• Egyptian Doberman, PLLC
• Eh Home Health of Austin, LLC (Enhabit Hospice)
• Eh Home Health of Austin, LLC (Enhabit Home Health)
• Rosine Valerie Ebude Ehade

• Oral and Maxillofacial Surgery (Dentist) in Austin, TX
• Providers in Austin, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.