Mahogani Eaton, DDS
Individual provider Active NPI Dentist · Wartburg, TN
NPI 1972348423 · NPPES record last updated Jun 26, 2024
Key facts
- NPI
- 1972348423
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 12532 (TN)
- Practice address
- 224 Old Mill Rd
Wartburg, TN 37887-4163 - Phone
- (423) 346-6221
- NPI assigned
- Jun 26, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12532 | TN | Yes |
Addresses
Primary practice location
224 Old Mill Rd
Wartburg, TN 37887-4163
Mailing address
300 S Tulane Ave Apt 2204
Oak Ridge, TN 37830-6776
Phone (229) 347-0893
Other providers in Wartburg, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.