Eric Louis Axelrode, DDS, MSD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

45640 Issued in CA

Practice address

1016 Country Club Dr
Moraga, CA 94556-1924

Phone

(925) 376-2800

NPI assigned

May 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Douglas James Hudson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Eric L. Axelrode, D.D.S., a Professional Corporation

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Moraga, CA
  • NPI 1376380899
  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1710193750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 TIA PL",
            "city": "MORAGA",
            "state": "CA",
            "postal_code": "945562622",
            "telephone_number": "925-631-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 COUNTRY CLUB DR",
            "city": "MORAGA",
            "state": "CA",
            "postal_code": "945561924",
            "telephone_number": "925-376-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AXELRODE",
        "first_name": "ERIC",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "45640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOUGLAS",
            "last_name": "HUDSON",
            "middle_name": "JAMES",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Georgiana Abel, LMFT
• Cameron Ledyard Aboudara, DDS
• Christy Cork Acker, M.S.P.T.
• Madison Colleen Afsari, RDHAP
• Scott C Anderson, MA, ATC
• Bay Area Sleep Apnea Solutions, LLC
• Stiev Owen Bobell, OTR/L
• Jessica Ann Brennan, PSYD
• Tiffany Amelia Chairudin, RPH
• Wendy Sue Chan, MPT

• Orthodontics and Dentofacial Orthopedics Dentistry in Moraga, CA
• Providers in Moraga, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.