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NPI Code Detail

MEDICARE: DR. JOSHUA JAMES EICHELBERGER DMD

MEDICARE: DR. JOSHUA JAMES EICHELBERGER DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryD011421AZ

General Provider Information

NPI Number : 1285366765
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSHUA JAMES EICHELBERGER DMD
Provider Business Mailing Address
First Line : 2177 S MCQUEEN RD APT 3092
Second Line :
City : CHANDLER
State : AZ
Zip : 85286-1852
Country : US
Telephone Number : 815-409-0549
Fax Number :
Provider Business Practice Location Address
First Line : 900 E FLORENCE BLVD STE D
Second Line :
City : CASA GRANDE
State : AZ
Zip : 85122-4673
Country : US
Telephone Number : 815-409-0549
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2022
Last Update Date : 06/24/2022

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