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Deactivated NPI 1104989904 Deactivated / Inactive NPI Male Practitioner

Dr. Vernon Stanley Eddlemon , DDS

Dentist - General Practice • Tempe, AZ

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Vernon Eddlemon has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 19, 2006
NPI Deactivation Date April 05, 2023
Total Practice Duration ~17 Years of Practice (2006 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Vernon Eddlemon, DDS was a registered Dentist - General Practice practicing in Tempe, AZ. Throughout an active medical career spanning 17 years, Dr. Eddlemon provided care at the practice location at 2076 E SOUTHERN AVE STE C102 until profile deactivation on 2023-04-05.

Practice Location & Contact Primary Location

Practice Address

2076 E Southern Ave Ste C102

Tempe, AZ 852827520

Telephone 4806995357
Fax 4806995387
Associated Practice Facility / Clinic
🏢 Nu Image Dentistry Facility NPI 1629131446

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Tempe, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 28.0 Yrs
State Avg: 16.4 Yrs
Regional Practice Density
82 Specialists

Practicing in Tempe, AZ (2600 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License AZ AZ 783

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.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated April 05, 2023

Record deactivated on April 05, 2023

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 2076 E SOUTHERN AVE STE C102, TEMPE, AZ 852827520 (Tel: 4806995357)

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Updated Business Mailing Address July 08, 2007

Registered at 2076 E SOUTHERN AVE STE C102, TEMPE, AZ 852827520 (Tel: 4806995357)

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Provider Name / Credentials Updated July 08, 2007

Recorded as VERNON EDDLEMON, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #AZ 783 in AZ)

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Initial NPI Registration & Enumeration December 19, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104989904
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 19, 2006
Last Update: July 08, 2007
Deactivation Date: April 05, 2023

Mailing Address

2076 E Southern Ave Ste C102

Tempe, AZ 852827520

Phone: 4806995357

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.