Brent D. Erickson, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

D10241 Issued in OR

Practice address

859 NE 7TH St
Grants Pass, OR 97526-1634

Phone

(541) 474-0860

NPI assigned

Jul 8, 2015

Last updated

Jul 8, 2015By 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

Other names 1

• Brent D. Erickson Professional name

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Desy P Wilson DDS Ms PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Grants Pass, OR
  • NPI 1588007264
  NPD (past)

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436313600000",
    "number": "1568845535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "859 NE 7TH ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261634",
            "telephone_number": "541-474-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 NE 7TH ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261634",
            "telephone_number": "541-474-0860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "BRENT",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-08",
        "last_updated": "2015-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENT",
            "last_name": "ERICKSON",
            "middle_name": "D.",
            "credential": "D.M.D., L.L.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Gladis Y Enriquez Verdugo
• Meri Jane Enyeart
• Janet M Eoff, MD
• Robert C Ericksen
• Erickson Dental Care LLC
• Ian Matthew Erickson, DMD
• Mart D Erickson, DDS
• Rachel Bella Erickson, DMD
• Sten Martin Erickson, D.M.D.
• Laura Erkeneff

• 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 Jul 8, 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.