Eric Lee Eltzroth, DDS
Individual provider Active NPI General Practice Dentistry · Eagle Point, OR
NPI 1699840959 · NPPES record last updated Aug 25, 2026
Key facts
- NPI
- 1699840959
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D11001 (OR)
- Practice address
- 217 W Main St
Eagle Point, OR 97524-0450 - Phone
- (541) 837-1675
- NPI assigned
- Nov 22, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221122000955 | OR | Order and Referring Only - Dentist |
2668840794 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50868 | CA | MD | General Practice Dentistry |
| D11001 | OR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Affordable Dentures & Implants - Medford, P.C. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 50868 | CA | |
| General Practice Dentistry | 1223G0001X | D11001 | OR | Yes |
| Dentist | 122300000X | 13865595-9925 | UT | |
| Dentist | 122300000X | D012094 | AZ |
Addresses
Primary practice location
217 W Main St
Eagle Point, OR 97524-0450
Mailing address
236 Loto St Unit 1065
Eagle Point, OR 97524-0860
Phone (530) 966-1284
Other providers in Eagle Point, OR
- Eagle Cove
- Eagle Point Dental Group,P.C.
- Eagle Point Eye Care, P.C.
- Eagle Point Family Dentistry
- Carmen D Edwards-Henry
- Emeritus Corporation
- Kendell Christine Erb
- Jacquelyn Fry
- Krsna Prema Dasa Fullman
- Thaddeus Gala
All providers in Eagle Point, OR · General Practice Dentistry in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.