NPIMap

Organization Active NPI

Erickson Dental Care LLC

  • General Practice Dentistry
  • Grants Pass, OR
National Provider Identifier
1780053249
Registry record updated Sep 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D9632 Issued in OR
Legal business name
ERICKSON DENTAL CARE LLC
Practice address
1224 NE 7TH St
Grants Pass, OR 97526-1424
Phone
(541) 476-3419
Fax
(541) 476-6985
NPI assigned
Sep 15, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2015

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

Authorized official

Name
Dr. Sten M Erickson, DMDNPI 1548549991
Title
Owner
Phone
(541) 476-3419

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D9632 OR Primary

Addresses

Primary practice location

1224 NE 7TH St
Grants Pass, OR 97526-1424

Mailing address

1224 NE 7TH St
Grants Pass, OR 97526-1424
Phone (541) 476-3419

National Provider Directory

National Provider Directory

Locations

1224 NE 7th St
Grants Pass, OR 97526
Phone (541) 476-3419

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442275200000",
    "number": "1780053249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 NE 7TH ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261424",
            "telephone_number": "541-476-3419",
            "fax_number": "541-476-6985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 NE 7TH ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261424",
            "telephone_number": "541-476-3419",
            "fax_number": "541-476-6985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERICKSON DENTAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-15",
        "last_updated": "2015-09-15",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "STEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-476-3419",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.