Individual provider Active NPI

Kurt Allan Eriksson, DMD

  • General Practice Dentistry
  • Jacksonville, NC
National Provider Identifier
1619319134
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13107 Issued in NC
Practice address
571 Yopp Rd Ste 308
Jacksonville, NC 28540-3683
Phone
(910) 716-0101
NPI assigned
Jul 25, 2013
Last updated
Jun 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS039589 PA
General Practice Dentistry 1223G0001X 13107 NC Primary

Addresses

Primary practice location

571 Yopp Rd Ste 308
Jacksonville, NC 28540-3683

Mailing address

571 Yopp Rd Ste 308
Jacksonville, NC 28540-3683
Phone (910) 716-0101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20250821004284 NC Order and Referring Only - DentistPractitioner - Dentist 7911407267

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS039589PAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lane and Associates Xli DDS PA Dentist CurrentSince Jun 29, 2025 Accepting new patients

Locations

571 Yopp Rd
Ste 308
Jacksonville, NC 28540
Phone (910) 716-0101

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1619319134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 YOPP RD STE 308",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285403683",
            "telephone_number": "910-716-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 YOPP RD STE 308",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285403683",
            "telephone_number": "910-716-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERIKSSON",
        "first_name": "KURT",
        "middle_name": "ALLAN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-25",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS039589",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "13107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.