Karl Eric Erickson, DDS
Individual provider Active NPI Dentist · Granite Falls, MN
NPI 1376648451 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1376648451
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- D9936 (MN)
- Practice address
- 871 Prentice Street
Granite Falls, MN 56241 - Phone
- (320) 564-2278
- NPI assigned
- Sep 14, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160217000632 | MN | Order and Referring Only - Other (Non-Physician) | 9335444116 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D9936 | MN | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D9936 | MN | Yes |
Addresses
Primary practice location
871 Prentice Street
Granite Falls, MN 56241
Mailing address
871 Prentice Street
Granite Falls, MN 56241
Phone (320) 564-2278
Other providers in Granite Falls, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.