Individual provider Active NPI

Merlin Erickson, DDS

  • General Practice Dentistry
  • Concord, NC
National Provider Identifier
1407694532
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13810 Issued in NC
Practice address
213 Church St NE
Concord, NC 28025-4763
Phone
(704) 782-1012
NPI assigned
Jul 15, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13810 NC Primary

Addresses

Primary practice location

213 Church St NE
Concord, NC 28025-4763

Mailing address

4850 Valhalla Dr
Woodbury, MN 55129-8426

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
13810NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
DRS J Loveland and R Walker III, PLLC General Practice CurrentSince Jul 21, 2024 Accepting new patients
Patricia London DDS PastSince Jul 21, 2024 Accepting new patients

Locations

213 Church St NE
Concord, NC 28025
Phone (704) 782-1012

Organizations & group practices 2

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": "1721001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1407694532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 VALHALLA DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551298426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 CHURCH ST NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280254763",
            "telephone_number": "704-782-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "MERLIN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "13810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.