NPIMap

Organization Active NPI

Erickson Pediatric Dentistry & Orthodontics PC

  • Pediatric Dentistry
  • Colorado Springs, CO
National Provider Identifier
1932358496
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DEN 9665 Issued in CO
Legal business name
ERICKSON PEDIATRIC DENTISTRY & ORTHODONTICS PC
Practice address
9334 Grand Cordera Pkwy
Colorado Springs, CO 80924-7000
Phone
(719) 282-6666
Fax
(719) 203-5477
NPI assigned
Sep 9, 2008
Last updated
Jun 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Authorized official

Name
Dawn Rush
Title
Business Manager
Phone
(719) 282-6666

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DEN 9665 CO Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DEN 9665 CO

Addresses

Primary practice location

9334 Grand Cordera Pkwy
Colorado Springs, CO 80924-7000

Mailing address

9334 Grand Cordera Pkwy
Colorado Springs, CO 80924-7000
Phone (719) 282-6666

Other identifiers 1

IdentifierTypeStateIssuer
9000146212MedicaidCO

National Provider Directory

National Provider Directory

Locations

8580 Scarborough Dr
Ste 220
Colorado Springs, CO 80920
Phone (719) 282-6666

9334 Grand Cordera Pkwy
Colorado Springs, CO 80924
Phone (719) 282-6666

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654819200000",
    "number": "1932358496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9334 GRAND CORDERA PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809247000",
            "telephone_number": "719-282-6666",
            "fax_number": "719-203-5477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9334 GRAND CORDERA PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809247000",
            "telephone_number": "719-282-6666",
            "fax_number": "719-203-5477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERICKSON PEDIATRIC DENTISTRY & ORTHODONTICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-09",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A",
        "authorized_official_last_name": "RUSH",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "719-282-6666"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "DEN 9665",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CO",
            "license": "DEN 9665",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000146212",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; 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.