Individual provider Active NPI

Erik S Swanson, D.M.D.

  • General Practice Dentistry
  • Visalia, CA
National Provider Identifier
1114082179
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
43399 Issued in CA
Practice address
2310 W Whitendale Ave, #C
Visalia, CA 93277-6131
Phone
(559) 732-4543
Fax
(559) 732-5172
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 43399 CA Primary

Addresses

Primary practice location

2310 W Whitendale Ave, #C
Visalia, CA 93277-6131

Mailing address

2310 W Whitendale Ave
C
Visalia, CA 93277-6131
Phone (559) 732-4543

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20181203003487 CA Order and Referring Only - DentistPractitioner - Dentist 8123330727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114082179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 W WHITENDALE AVE",
            "address_2": "C",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932776131",
            "telephone_number": "559-732-4543",
            "fax_number": "559-732-5172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 W WHITENDALE AVE, #C",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932776131",
            "telephone_number": "559-732-4543",
            "fax_number": "559-732-5172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "ERIK",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.