Kathy Lynn Eaton, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019.025342 Issued in IL

Practice address

2106 W Springfield Ave
Champaign, IL 61821-2933

Phone

(217) 954-1347

Fax

(217) 954-1361

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374624000000",
    "number": "1821100371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 W SPRINGFIELD AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618212933",
            "telephone_number": "217-954-1347",
            "fax_number": "217-954-1361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 W SPRINGFIELD AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618212933",
            "telephone_number": "217-954-1347",
            "fax_number": "217-954-1361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "KATHY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2013-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019025342",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.025342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9184608",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Champaign, IL
• Providers in Champaign, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; 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.