NPIMap

Organization Active NPI

Robert E. Erickson, DMD, PLLC

Doing business as Erickson's Extraction and Denture Center

  • Dental Clinic/Center
  • Bangor, ME
National Provider Identifier
1487181723
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
3214 Issued in ME
Legal business name
ROBERT E. ERICKSON, DMD, PLLC
Doing business as
Erickson's Extraction and Denture Center
Practice address
12 Stillwater Ave Ste 6
Bangor, ME 04401-3984
Phone
(207) 992-2060
Fax
(207) 262-0424
NPI assigned
May 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Robert E Erickson, DMD
Title
Owner
Phone
(207) 992-2060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 3214 ME Primary

Addresses

Primary practice location

12 Stillwater Ave Ste 6
Bangor, ME 04401-3984

Mailing address

12 Stillwater Ave Ste 6
Bangor, ME 04401-3984
Phone (207) 992-2060

Other names 1

  • Erickson's Extraction and Denture Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1487181723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 STILLWATER AVE STE 6",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013984",
            "telephone_number": "207-992-2060",
            "fax_number": "207-262-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 STILLWATER AVE STE 6",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013984",
            "telephone_number": "207-992-2060",
            "fax_number": "207-262-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT E. ERICKSON, DMD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-17",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-992-2060",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ME",
            "license": "3214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Erickson's Extraction and Denture Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.