Individual provider Active NPI

Erik William Marksberry, D.D.S.

  • General Practice Dentistry
  • Coon Rapids, MN
National Provider Identifier
1124017603
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D11789 Issued in MN
Practice address
10756 Butternut St NW
Coon Rapids, MN 55448-4448
Phone
(763) 757-4170
Fax
(763) 757-7940
NPI assigned
Oct 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 D11789 MN Primary

Addresses

Primary practice location

10756 Butternut St NW
Coon Rapids, MN 55448-4448

Mailing address

10756 Butternut St NW
Coon Rapids, MN 55448-4448
Phone (763) 757-4170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D11789MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Dental P.a. General Practice Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1124017603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10756 BUTTERNUT ST NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554484448",
            "telephone_number": "763-757-4170",
            "fax_number": "763-757-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10756 BUTTERNUT ST NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554484448",
            "telephone_number": "763-757-4170",
            "fax_number": "763-757-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKSBERRY",
        "first_name": "ERIK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.