Fairmont Family Dentistry, PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D10871 Issued in MN

Legal business name

FAIRMONT FAMILY DENTISTRY, PA

Practice address

202 N Park St
Fairmont, MN 56031-2824

Phone

(507) 238-2818

Fax

(507) 235-8914

NPI assigned

Apr 15, 2008

Last updated

Apr 15, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jon Thomas Eriskson

Title

President

Phone

(507) 238-2812

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jon T Erickson, D.D.S.

  • Dentist
  • Fairmont, MN
  • NPI 1033127378
  NPD (past)

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1356515969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 N PARK ST",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560312824",
            "telephone_number": "507-238-2818",
            "fax_number": "507-235-8914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 N PARK ST",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560312824",
            "telephone_number": "507-238-2818",
            "fax_number": "507-235-8914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRMONT FAMILY DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "ERISKSON",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "507-238-2812"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "D10871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luke K Espelund, MD
• Eunoia Family Resource Center PA
• Alisa Sarah Eytcheson, NP-C
• Fairmont Chiropractic & Acupuncture Healthcare, LTD
• Fairmont Dental Professionals LLC
• Fairmont Orthopedics & Sports Medicine P a (Center for Specialty Care)
• Fairmont Orthopedics & Sports Medicine, PA (Center for Specialty Care)
• Fairmont Orthopedics & Sports Medicine, PA (Center for Specialty Care)
• Samantha Augusta Farnum, APRN
• Robert Fernandez, MD

• Dental Clinic/Center in Fairmont, MN
• Providers in Fairmont, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.