Ian Matthew Erickson, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D9158 Issued in OR

Practice address

1224 NE 7TH St
Grants Pass, OR 97526-1424

Phone

(541) 476-3419

NPI assigned

Sep 6, 2008

Last updated

Sep 6, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

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.

• Erickson Dental Care LLC

  • General Practice Dentistry
  • Grants Pass, OR
  • NPI 1780053249
  NPD (past)
• Mart D Erickson DDS PC

  • General Practice Dentistry
  • Grants Pass, OR
  • NPI 1164414470
  NPD (past)

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

{
    "created_epoch": "1220659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220659200000",
    "number": "1528216256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 HASKELL ST APT 3",
            "city": "CENTRAL POINT",
            "state": "OR",
            "postal_code": "975022395",
            "telephone_number": "971-237-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 NE 7TH ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261424",
            "telephone_number": "541-476-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "IAN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-06",
        "last_updated": "2008-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D9158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meri Jane Enyeart
• Janet M Eoff, MD
• Robert C Ericksen
• Erickson Dental Care LLC
• Brent D. Erickson, D.M.D.
• Mart D Erickson, DDS
• Rachel Bella Erickson, DMD
• Sten Martin Erickson, D.M.D.
• Laura Erkeneff
• Jon Edwin Lloyd Ermshar, M.D.

• Dentist in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.