Provider Demographics
NPI:1275550907
Name:JEFFREY EBY, DMD INC.
Entity Type:Organization
Organization Name:JEFFREY EBY, DMD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:R
Authorized Official - Last Name:EBY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:717-859-4170
Mailing Address - Street 1:240 N 7TH ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:AKRON
Mailing Address - State:PA
Mailing Address - Zip Code:17501-1361
Mailing Address - Country:US
Mailing Address - Phone:717-859-4170
Mailing Address - Fax:717-859-4174
Practice Address - Street 1:240 N 7TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:AKRON
Practice Address - State:PA
Practice Address - Zip Code:17501-1361
Practice Address - Country:US
Practice Address - Phone:717-859-4170
Practice Address - Fax:717-859-4174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030794L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty