Jeffrey M Erickson, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

50245 Issued in CA

Practice address

20265 Lake Chabot Rd
Castro Valley, CA 94546-5307

Phone

(510) 881-8010

Fax

(510) 538-0120

NPI assigned

Feb 7, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Creative Dimensions in Dentistry

  • Dentist
  • Castro Valley, CA
  • NPI 1396957866
  NPD (past)
• Sierra Kress Dental

  dba Creative Dimensions in Dentistry

  • Dental Clinic/Center
  • Castro Valley, CA
  • NPI 1932811734
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053451435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 WASHINGTON ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941093915",
            "telephone_number": "510-390-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20265 LAKE CHABOT RD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465307",
            "telephone_number": "510-881-8010",
            "fax_number": "510-538-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elite Care LLC.
• Ashlyn Ellis
• Glen Stephen Ellis, C.P.O.
• Elyssa Feinberg, MD Trauma and Acute Care Surgery
• Mei Yin Eng, OTR/L
• Ian Zachary Erlich
• Joseph Alexander Escobedo
• Jaelene Espinosa
• Ashley Rose Etchison, MD
• Jazmin Oropeza Eufracio

• General Practice Dentistry in Castro Valley, CA
• Providers in Castro Valley, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.