Ben Wilder Eby, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

26164 Issued in CA

Practice address

4220 Phelan Road
Phelan, CA 92371

Phone

(760) 868-2786

Fax

(760) 868-5783

NPI assigned

Jul 16, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• J.Caballero D.D.S., Inc

  • Dentist
  • Phelan, CA
  • NPI 1093388589
  NPD (past)

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216166400000",
    "number": "1992969216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 PHELAN ROAD",
            "city": "PHELAN",
            "state": "CA",
            "postal_code": "92371",
            "telephone_number": "760-868-2786",
            "fax_number": "760-868-5783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 PHELAN ROAD",
            "city": "PHELAN",
            "state": "CA",
            "postal_code": "92371",
            "telephone_number": "760-868-2786",
            "fax_number": "760-868-5783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBY",
        "first_name": "BEN",
        "middle_name": "WILDER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-16",
        "last_updated": "2008-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "26164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Patricia Joan Felt, PT
• Ariel Amethyst Ferrara, MSN, RN, FNP-BC
• Formulation Materials

• All providers in Phelan, CA
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.