NPIMap

Organization Active NPI

Russell Erickson DDS PC

  • Dental Clinic/Center
  • Clackamas, OR
National Provider Identifier
1497922041
Registry record updated May 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D6120 Issued in OR
Legal business name
RUSSELL ERICKSON DDS PC
Practice address
13530 SE 97TH Ave
Clackamas, OR 97015-7691
Phone
(503) 353-1471
Fax
(503) 353-1473
NPI assigned
May 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2008

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

Authorized official

Name
Dr. Russell Erickson III, DDSNPI 1871591594
Title
Dentist/Owner
Phone
(503) 353-1471

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D6120 OR Primary

Addresses

Primary practice location

13530 SE 97TH Ave
Clackamas, OR 97015-7691

Mailing address

13530 SE 97TH Ave
Clackamas, OR 97015-7691
Phone (503) 353-1471

National Provider Directory

National Provider Directory

Locations

13530 SE 97th Ave
Clackamas, OR 97015
Phone (503) 353-1471

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210636800000",
    "number": "1497922041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13530 SE 97TH AVE",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970157691",
            "telephone_number": "503-353-1471",
            "fax_number": "503-353-1473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13530 SE 97TH AVE",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970157691",
            "telephone_number": "503-353-1471",
            "fax_number": "503-353-1473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL ERICKSON DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-13",
        "last_updated": "2008-05-13",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "503-353-1471",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OR",
            "license": "D6120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; 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.