NPIMap

Organization Active NPI

Erickson Dental Group

  • Dentist
  • Urbandale, IA
National Provider Identifier
1831267913
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7898 Issued in IA
Legal business name
ERICKSON DENTAL GROUP
Practice address
7117 Hickman Road
Urbandale, IA 50322-4851
Phone
(515) 276-4981
Fax
(515) 276-4864
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Bradley S Erickson, DDSNPI 1447385521
Title
Dentist
Phone
(515) 276-4981

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 7898 IA Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 08410 IA

Addresses

Primary practice location

7117 Hickman Road
Urbandale, IA 50322-4851

Mailing address

7117 Hickman Road
Urbandale, IA 50322-4851
Phone (515) 276-4981

Other identifiers 1

IdentifierTypeStateIssuer
0037333MedicaidIA

National Provider Directory

National Provider Directory
Tax ID family
Erickson Dental Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831267913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7117 HICKMAN ROAD",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503224851",
            "telephone_number": "515-276-4981",
            "fax_number": "515-276-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7117 HICKMAN ROAD",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503224851",
            "telephone_number": "515-276-4981",
            "fax_number": "515-276-4864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERICKSON DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "515-276-4981",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IA",
            "license": "7898",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IA",
            "license": "08410",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0037333",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbandale, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.