Stephen L Ericksen, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

5314850-9922 Issued in UT

Practice address

895 N 900 E
American Fork, UT 84003-9183

Phone

(801) 763-4164

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AK

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 and National Provider Directory roles.

• Dr Quinn Schiffman DDS LLC

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  • NPI 1811462120
  NPD (past)
• Dr. Albert Clark DDS, PC

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  • NPI 1972772853
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1194807156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 N 900 E",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840039183",
            "telephone_number": "801-763-4164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 N 900 E",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840039183",
            "telephone_number": "801-763-4164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1355 N University Ave Ste 320",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846042721",
            "country_code": "US",
            "telephone_number": "801-375-1750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERICKSEN",
        "first_name": "STEPHEN",
        "middle_name": "L",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "DEND1161",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "5314850-9922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD5568",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED DENTIST",
            "identifier": "1161",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED DENTIST",
            "identifier": "5314850-9922",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aubrey Elizabeth Elms
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• Courtney Marie Erazo, NP
• David G. Erekson, D.D.S.
• Brandelin Stoneman Erickson, LCSW
• Alyssa Esplin
• Audrey Faith Shelley Estrada
• Jason Howard Eves, M.D.
• Amanda Jane Fairbanks

• Dentist in American Fork, UT
• Providers in American Fork, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.