Eric Carl Edstrom, D.D.S., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

36237 Issued in CA

Practice address

2780 State St
Suite 4
Santa Barbara, CA 93105-5518

Phone

(805) 687-5561

Fax

(805) 687-0810

NPI assigned

Jul 4, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1183507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902004666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 STATE ST",
            "address_2": "SUITE 4",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931055518",
            "telephone_number": "805-687-5561",
            "fax_number": "805-687-0810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 STATE ST",
            "address_2": "SUITE 4",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931055518",
            "telephone_number": "805-687-5561",
            "fax_number": "805-687-0810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDSTROM",
        "first_name": "ERIC",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "36237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Suzette Eddy, RN, MSW
• Edelweiss Home Inc.
• Amanda Edmonson, PA-C
• Alan J Edmundson, PT
• Talon Edson
• Rebecca Edwards-Bischoff, RN
• Allyson J Edwards, O.T.
• Autumn Edwards, M.D.
• Victoria Lynn Edwards, RN
• James V Egan, M.D.

• All providers in Santa Barbara, CA
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.