Susan Kristen Erickson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

063285 Issued in NY

Practice address

11535 Main Rd
Mattituck, NY 11952-1687

Phone

(631) 298-5021

NPI assigned

Apr 21, 2022

Last updated

Dec 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Frank a. Kestler, D.D.S.

  • Dentist
  • Mattituck, NY
  • NPI 1225403496
  NPD (past)

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

{
    "created_epoch": "1650499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1437893013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11535 MAIN RD",
            "city": "MATTITUCK",
            "state": "NY",
            "postal_code": "119521687",
            "telephone_number": "631-298-5021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11535 MAIN RD",
            "city": "MATTITUCK",
            "state": "NY",
            "postal_code": "119521687",
            "telephone_number": "631-298-5021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 Hempstead Tpke",
            "address_purpose": "LOCATION",
            "city": "East Meadow",
            "state": "NY",
            "postal_code": "115541859",
            "country_code": "US",
            "telephone_number": "516-572-8774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "SUSAN",
        "middle_name": "KRISTEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-21",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "063285",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Donato
• East End Physical Therapy, PC
• East End RN Care P.C.
• David Howan Eilbert, O.D.
• Jennifer Frances Elder, LMSW
• Alyssa Veneruso Feinman, D.D.S.
• Devan Fitzpatrick, LMSW
• Frank a. Kestler, D.D.S.
• Lindsey Katherine Gallagher, BCBA/LBA
• Kiera Gavan

• Dentist in Mattituck, NY
• Providers in Mattituck, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; 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.