Individual provider Active NPI

Jonathan Andrew Erhardt, DDS

  • General Practice Dentistry
  • Marysville, WA
National Provider Identifier
1427120492
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00006466 Issued in WA
Practice address
7825 47TH Ave NE
Marysville, WA 98270-3732
Phone
(360) 659-1223
NPI assigned
Nov 15, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 DE00006466 WA Primary

Addresses

Primary practice location

7825 47TH Ave NE
Marysville, WA 98270-3732

Mailing address

4804 Hartford Way
Mukilteo, WA 98275-6004
Phone (425) 315-9928

Other identifiers 1

IdentifierTypeStateIssuer
5042296MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150312002424 WA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3779809587

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE00006466WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
John D Hixson DDS PS Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427120492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4804 HARTFORD WAY",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982756004",
            "telephone_number": "425-315-9928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7825 47TH AVE NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982703732",
            "telephone_number": "360-659-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERHARDT",
        "first_name": "JONATHAN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00006466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5042296",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, WA

Sources for this page

Verify at the official NPI Registry.