Erik Klintmalm, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

34105 Issued in TX

Practice address

2403 Lacy LN
Carrollton, TX 75006

Phone

(972) 869-3789

NPI assigned

Jun 12, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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 and National Provider Directory roles.

• Gulfside Dental

  • Dentist
  • Beaumont, TX
  • NPI 1609132612
  NPD (past)

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1508359761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3808 MIRAMAR AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752053126",
            "telephone_number": "214-415-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 LACY LN",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "75006",
            "telephone_number": "972-869-3789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINTMALM",
        "first_name": "ERIK",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-12",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "10882",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00203718",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daron Ray Kinney, MS, ATC, LAT
• Kiran P Shah, MD, PA
• Papiereygan Klaff, FNP-BC
• Brittany Klein
• Kerri Klentzman
• Ryan Austin Klitgaard, MD
• Jon T Koblensvik, DDS
• Neza Kocijan
• Abigail Koczo
• Mohamad-Ali Samir Kolailat, D.C

• General Practice Dentistry in Carrollton, TX
• Providers in Carrollton, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; 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.