TAMARA EATON DDS PC NPI 1245605542

NPI Information

NPI: 1245605542
Provider Name: TAMARA EATON DDS PC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
1213 E COOLSPRING AVE
MICHIGAN CITY, IN
ZIP 46360
Phone: (219) 872-9151
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TAMARA EATON DDS PC is a general practice dentist in Michigan City, IN. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. TAMARA EATON DDS PC NPI is 1245605542. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1213 E COOLSPRING AVE
MICHIGAN CITY, IN
ZIP 46360-319
Phone: (219) 872-9151
Fax: (219) 873-3341

The provider's authorized official is Candace Wilde .
The authorized official title is Practice Administrator and has the following contact phone number (219) 210-3495.

The enumeration date for this NPI number is 12/11/2015 and was last updated on 12/11/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	12009857A	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	200384300A	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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