Stacey Ann Eby, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

5909 Issued in WI

Practice address

211 Memorial Dr
Fort Atkinson, WI 53538-1981

Phone

(920) 563-2928

NPI assigned

Dec 12, 2006

Last updated

Jan 11, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Eby Family Dental

  • General Practice Dentistry
  • Fort Atkinson, WI
  • NPI 1457472797
  Authorized official Same address or phone
• Eby Family Dental of Jefferson

  • Dental Clinic/Center
  • Jefferson, WI
  • NPI 1881307882
  NPD

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1801957030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 MEMORIAL DR",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381981",
            "telephone_number": "920-563-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 MEMORIAL DR",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381981",
            "telephone_number": "920-563-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBY",
        "first_name": "STACEY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "5909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Gayle Dunkel, DPT
• Dycora Transitional Health - Fort Atkinson LLC
• Hannah Dyer, COTA/L
• E C Jiongco, MD, SC
• Eby Family Dental
• Michelle Eichenberg
• Brett William Eliszewski
• Enza Elrod, RDH
• Carol A Erdman, LCSW, CADCIII
• Marc H Erickson, MD

• Dentist in Fort Atkinson, WI
• Providers in Fort Atkinson, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.