Thomas E Ericksen, DDS, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5796632-9922 Issued in UT

Legal business name

THOMAS E ERICKSEN, DDS, LLC

Doing business as

Kaysville Dental Clinic

Practice address

690 N Main St
Kaysville, UT 84037-3132

Phone

(801) 719-6621

NPI assigned

Jun 9, 2016

Organization subpart

No

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

Authorized official

Name

Thomas Ericksen, DDSNPI 1437563103

Title

Dentist/Owner

Phone

(801) 540-6377

Specialties & licenses 1

Addresses

Other names 1

• Kaysville Dental Clinic Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas E Ericksen, DDS

  • Dentist
  • Kaysville, UT
  • NPI 1437563103
  NPD (past) Authorized official
• Paul M Hoeft, DDS

  • General Practice Dentistry
  • Kaysville, UT
  • NPI 1720108061
  NPD (past)

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465430400000",
    "number": "1346699311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 W 525 S",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840415534",
            "telephone_number": "801-540-6377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 N MAIN ST",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840373132",
            "telephone_number": "801-719-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS E ERICKSEN, DDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-09",
        "last_updated": "2016-06-09",
        "status": "A",
        "authorized_official_last_name": "ERICKSEN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "801-540-6377",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "5796632-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kaysville Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tanner Memorial Clinic
• Taylor and Taylor Consulting (White Pine Recovery)
• Levi Taylor, D.D.S.
• Mark A Taylor, O.D.
• The Diamond Tree LLC (Diamond Tree Recovery)
• Derek Thomas
• Karen Thomas
• Ryan E Thomas, D.D.S
• Tracy Hugh Tippets, RPA
• Todd N. Grant DC PC

• General Practice Dentistry in Kaysville, UT
• Providers in Kaysville, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; 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.