Eagle River Dental Associates

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20644 Issued in TX

Legal business name

EAGLE RIVER DENTAL ASSOCIATES

Doing business as

Care Plus Dental Associates

Practice address

3201 University Dr E
Suite 170
Bryan, TX 77802-3475

Phone

(979) 774-1255

NPI assigned

Mar 10, 2014

Last updated

Mar 10, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Keith T Grimm, DMD

Title

President

Phone

(979) 774-1255

Specialties & licenses 1

Addresses

Other names 1

• Care Plus Dental Associates Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jason Dodge, DDS

  • Dentist
  • Bryan, TX
  • NPI 1477332302
  NPD (past)
• Lawrence Daniel Lawson, DDS

  • Dentist
  • Bryan, TX
  • NPI 1770746497
  NPD (past)

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

{
    "created_epoch": "1394409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394409600000",
    "number": "1841616216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 UNIVERSITY DR E",
            "address_2": "SUITE 170",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 UNIVERSITY DR E",
            "address_2": "SUITE 170",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023475",
            "telephone_number": "979-774-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE RIVER DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-10",
        "last_updated": "2014-03-10",
        "status": "A",
        "authorized_official_last_name": "GRIMM",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "979-774-1255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Care Plus Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Dundas, FNP
• Justin Ryan Dunn, PHARMD
• Charis Durham, M.D.
• Dva Renal Healthcare Inc (Briarcrest Dialysis)
• Deborah Dyjak Diaz, LCSW
• Obinna Kelechi Echeruo, MD
• Alyssa Eckert
• Pascal Egbe Egbe, DNP-FNP
• Ronald R Eikenhorst, MD
• Kristin Eiland

• General Practice Dentistry in Bryan, TX
• Providers in Bryan, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; 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.