NPIMap

Individual provider Active NPI

Erik W. Permann, DDS

  • Dentist
  • Hereford, TX
National Provider Identifier
1306159371
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D-4455 Issued in ID
Practice address
125 W Park Ave
Hereford, TX 79045-4201
Phone
(806) 364-7688
Fax
(806) 364-7694
NPI assigned
Jul 20, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 25801 TX
Dentist 122300000X D-4455 ID Primary

Addresses

Primary practice location

125 W Park Ave
Hereford, TX 79045-4201

Mailing address

285 Canyon Crest Dr.
Twin Falls, ID 83301
Phone (208) 733-9999

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
25801TXMDClinical Psychologist
D-4455IDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Dental Care Group, PLLC Dentist 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": "1279584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1306159371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 CANYON CREST DR.",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "83301",
            "telephone_number": "208-733-9999",
            "fax_number": "208-733-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 W PARK AVE",
            "city": "HEREFORD",
            "state": "TX",
            "postal_code": "790454201",
            "telephone_number": "806-364-7688",
            "fax_number": "806-364-7694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERMANN",
        "first_name": "ERIK",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-20",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "25801",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D-4455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hereford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.