Eric M Nordstrom, DDS, MD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

MEDS7783 Issued in AK

Practice address

2041 Tributary Cir
Anchorage, AK 99516-7318

Phone

(503) 545-9249

NPI assigned

Aug 1, 2006

Last updated

Oct 5, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 12, 2024 through Jan 12, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Eric Nordstrom DDS, MD, Inc

  dba Alaska Center for Oral and Facial Surgery

  • Ambulatory Surgical Clinic/Center
  • Anchorage, AK
  • NPI 1285410340
  NPD Authorized official

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444003200000",
    "number": "1316954670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 TRIBUTARY CIR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995167318",
            "telephone_number": "503-545-9249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 TRIBUTARY CIR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995167318",
            "telephone_number": "503-545-9249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDSTROM",
        "first_name": "ERIC",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2015-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "1136",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AK",
            "license": "MEDS7783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miriam R Nolte, MD
• Zachary Scott Noonan
• Emily Noone, PT
• Norbu Linka
• Nordstrom Inc & Subsidiaries
• Leroy D. Nordstrom, D.C.
• Chloe Noelle Nordwall
• Gabriel Rodriguez Noriega
• Norman J. Wilder, M.D.
• Daniel J Norman, PT

• Oral & Maxillofacial Surgery (D.M.D.) in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.