Erika M Theisen DDS PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12795 Issued in MN

Legal business name

ERIKA M THEISEN DDS PLLC

Practice address

22 2ND Ave S
Sauk Rapids, MN 56379-1408

Phone

(320) 252-7806

Fax

(320) 252-9044

NPI assigned

May 22, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Erika Marie Theisen, DDS

Title

Owner

Phone

(320) 252-7806

Specialties & licenses 1

Addresses

Other names 1

• THEISEN DENTAL Doing business as

Locations

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

{
    "created_epoch": "1432252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432252800000",
    "number": "1538548573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 2ND AVE S",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563791408",
            "telephone_number": "320-252-7806",
            "fax_number": "320-252-9044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 2ND AVE S",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563791408",
            "telephone_number": "320-252-7806",
            "fax_number": "320-252-9044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIKA M THEISEN DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-22",
        "last_updated": "2015-05-22",
        "status": "A",
        "authorized_official_last_name": "THEISEN",
        "authorized_official_first_name": "ERIKA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-252-7806",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THEISEN DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brian John Dragich, PHARMD
• John Dragich, RPH
• Joann Mary Dreher, CNP
• Anthony Joseph Dungey, DC
• Dvorak Cataract and Eye Laser Clinic, PA
• Essilor Laboratories of America, Inc
• Essilor Laboratories of America, Inc
• Grace Kathleen Euteneuer
• Evergreen Counseling LLC
• Mable Fale

• General Practice Dentistry in Sauk Rapids, MN
• Providers in Sauk Rapids, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; 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.