Provider Demographics
NPI:1598884769
Name:EBERHART, DONALD A (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:A
Last Name:EBERHART
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14815 W BELL RD STE 202
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-7611
Mailing Address - Country:US
Mailing Address - Phone:623-547-5400
Mailing Address - Fax:623-792-8734
Practice Address - Street 1:14815 W BELL RD STE 202
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-7611
Practice Address - Country:US
Practice Address - Phone:623-547-5400
Practice Address - Fax:623-792-8734
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD52491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice