Individual provider Active NPI

Benjamin David Eaker, DMD

  • General Practice Dentistry
  • Spindale, NC
National Provider Identifier
1861177263
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13367 Issued in NC
Practice address
837 Thunder Rd
Spindale, NC 28160-1152
Phone
(828) 287-7592
NPI assigned
Jun 21, 2023
Last updated
Dec 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 13367 NC Primary

Addresses

Primary practice location

837 Thunder Rd
Spindale, NC 28160-1152

Mailing address

101 Life Enrichment Blvd
Shelby, NC 28150-3690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13367NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
JD Hall DMD PA General Practice CurrentSince Dec 22, 2024 Accepting new patients
Kendalyn Lutz-Craver DDS PA General Practice PastSince Aug 1, 2023 Accepting new patients

Locations

837 Thunder Rd
Spindale, NC 28160
Phone (828) 287-7592

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1687305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1861177263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 LIFE ENRICHMENT BLVD",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 THUNDER RD",
            "city": "SPINDALE",
            "state": "NC",
            "postal_code": "281601152",
            "telephone_number": "828-287-7592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAKER",
        "first_name": "BENJAMIN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-21",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "13367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spindale, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; 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.