DEREK J EATON DDS PLLC (NPI# 1639456486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639456486 |
| Entity Type | Organization |
| Organization Name | DEREK J EATON DDS PLLC |
| Other Organization Name | CAROLINA ORAL & MAXILLOFACIAL SURGERY |
| Practice Address |
660 Summit Crossing Pl Suite 303 Gastonia NC 28054-2104 |
| Practice Telephone | 7048650081 |
| Practice Fax Number | 7048656004 |
| Mailing Telephone | 7048650081 |
| Mailing Fax Number | 7048656004 |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2012-08-28 |
| Authorized Official Name | DR. DEREK JAMES EATON (OWNER) |
| Authorized Official Telephone | 7048650081 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
9225 | NC | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Carolina Oral & Maxillofacial Surgery | Doing Business As Name - Organization |
| Street Address |
660 SUMMIT CROSSING PL SUITE 303 |
| City | GASTONIA |
| State | NC |
| Zip Code | 28054-2104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407842727 | Paula A Lundgren | Surgery | 660 Summit Crossing Pl, Suite 203, Gastonia, NC 28054-2104 | 2005-09-22 |
| 1528550415 | Emily Rayfield | Nurse Practitioner | 660 Summit Crossing Pl, Gastonia, NC 28054-2104 | 2018-06-06 |
| 1700259199 | Rhodenna M Arn | Nurse Practitioner | 660 Summit Crossing Pl, Gastonia, NC 28054-2104 | 2015-11-06 |
| 1477649432 | Derek J Eaton | Dentist | 660 Summit Crossing Pl, Suite 303, Gastonia, NC 28054-2104 | 2006-10-05 |
| 1922067057 | Perry W Aycock Jr. | Internal Medicine | 660 Summit Crossing Pl, Gastonia, NC 28054-2104 | 2006-03-18 |
| 1831158963 | Jasper Carl Stowe IIi | Physician Assistant | 660 Summit Crossing Pl, Gastonia, NC 28054-2104 | 2006-03-18 |
| 1801855085 | Chandra Shakara Shastry | Internal Medicine | 660 Summit Crossing Pl, Gastonia, NC 28054-2104 | 2006-03-17 |
| 1659349744 | David Timothy Thomas | Internal Medicine | 660 Summit Crossing Pl, Suite 301, Gastonia, NC 28054-2104 | 2006-03-14 |
| 1568430650 | Ronald Wyman Digby | Internal Medicine | 660 Summit Crossing Pl, Gastonia, NC 28054-2104 | 2006-03-14 |
| 1770551020 | Harold Fite | Physician Assistant | 660 Summit Crossing Pl, Gastonia, NC 28054-2104 | 2006-03-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671423 | Michaela Karsyn Morris | Behavioral Analyst | 2875 Court Dr. B, Gastonia, NC 28054 | 2019-10-21 |
| 1982263810 | Brenda Sue Fox | Occupational Therapist | Brian Center, 969 Cox Rd, Gastonia, NC 28054 | 2019-06-13 |
| 1174096911 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 469 Hospital Drive, Suite B1, Gastonia, NC 28054 | 2019-01-04 |
| 1255801817 | Jarae Mcswain | Counselor | 1558 Union Road, Ste F, Gastonia, NC 28054 | 2018-11-27 |
| 1427549807 | Alterman & Dhillon Charlotte Metro, Pplc | Dentist | 2205 E. Franklin Blvd, Ste 110, Gastonia, NC 28054 | 2018-05-22 |
| 1871083147 | Terrence Lamont Campbell | Dentist | 2641 Court Dr Ste A, Gastonia, NC 28054 | 2018-05-13 |
| 1861995367 | Jefferson and Jefferson LLC. | Respite Care | 945 East 6 Ave, Gastonia, NC 28054 | 2018-03-12 |
| 1790154912 | Tyler Adcock | Pharmacist | 2324 South New Hope Rd, Gastonia, NC 28054 | 2015-09-17 |
| 1922481894 | Alesha Nicole Logan | Nurse Practitioner | 1895 Hoffman Rd Ste A, Gastonia, NC 28054 | 2015-07-09 |
| 1457732596 | Buffie Baker Eller | Counselor | 2005 Flint Lane, Gastonia, NC 28054 | 2015-06-15 |
| Find all providers in zip 28054 | ||||
| Taxonomy Code | 261QS0112X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912468463 | Providence Oral Surgery and Dental Implant Center | Clinic/Center | 102 Waxhaw Professional Park Dr Ste G, Waxhaw, NC 28173-5024 | 2019-03-27 |
| 1356699094 | Shawana Patterson, Dds, Pa | Clinic/Center | 801 Phillips Ave Ste 105, High Point, NC 27262-7293 | 2012-08-28 |
| 1043773898 | William V Linger D D S Pa | Clinic/Center | 435 N Wendover Rd, Charlotte, NC 28211-1064 | 2019-04-09 |
| 1245627819 | Jeffrey S. Almony, Md, Dds, Pa | Clinic/Center | 125 Murray Hill Rd, Suite C, Southern Pines, NC 28387-6354 | 2015-04-22 |
| 1649694415 | Jenny Lane, Dds, Md, Pllc | Clinic/Center | 4 Vanderbilt Park Dr Ste 210, Asheville, NC 28803-1759 | 2014-02-13 |
| 1639353659 | Iredell Oral & Facial Surgery PC | Clinic/Center | 229 Medical Park Rd, Suite 310, Mooresville, NC 28117-8543 | 2007-12-27 |
| 1831303429 | Dr. Juan G. Lopez Dmd Dds Pa | Clinic/Center | 1711 Montford Dr, Charlotte, NC 28209-3721 | 2007-05-10 |
| 1770637779 | K. Kevin Neshat, Dds, Md, Pa | Clinic/Center | 8305 Falls of Neuse Rd, Suite 105, Raleigh, NC 27615-3546 | 2007-01-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.