Jonathan D Eagle DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

2901015645 Issued in MI

Legal business name

JONATHAN D EAGLE DDS PC

Practice address

1750 Grand Ridge Court NE
Suite 202
Grand Rapids, MI 49525

Phone

(616) 361-9330

Fax

(616) 361-7095

NPI assigned

Feb 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Johnathan D Eagle, DDS PC

Title

President

Phone

(616) 361-9330

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jonathan Eagle, D.D.S

  • Dentist
  • Grand Rapids, MI
  • NPI 1720261126
  NPD

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700611200000",
    "number": "1982744249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 GRAND RIDGE COURT NE",
            "address_2": "SUITE 202",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49525",
            "telephone_number": "616-361-9330",
            "fax_number": "616-361-7095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 GRAND RIDGE COURT NE",
            "address_2": "SUITE 202",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49525",
            "telephone_number": "616-361-9330",
            "fax_number": "616-361-7095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN D EAGLE DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2023-11-22",
        "status": "A",
        "authorized_official_last_name": "EAGLE",
        "authorized_official_first_name": "JOHNATHAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-361-9330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS PC"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901015645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Dominque Joldersma, PA-C
• Joanne Joliat, PA-C
• Jolie J. Brown, LMSW LLC
• Brianna Jolly
• Jonas Paul Eyewear, LLC
• Alan S Jones, MD
• Amber Jones
• Amy Lynn Jones, RDH
• Aniyah Jones
• Ariel Jones

• Dentist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.