Mark Scott Ericson, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

60084 Issued in CA

Practice address

1320 Apple Ave Ste 104
Hayward, CA 94541-1552

Phone

(360) 870-9097

Fax

(510) 582-8147

NPI assigned

Feb 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 20, 2025 through Feb 20, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mericson137933@hisp.ehr.sutterhealth.org

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.

• James S Mossop DDS Inc

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Hayward, CA
  • NPI 1205906526
  NPD (past)

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333497600000",
    "number": "1952374761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 APPLE AVE STE 104",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945411552",
            "telephone_number": "360-870-9097",
            "fax_number": "510-582-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 APPLE AVE STE 104",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945411552",
            "telephone_number": "360-870-9097",
            "fax_number": "510-582-8147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICSON",
        "first_name": "MARK",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2012-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "22DI02230300",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "23691",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "60084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Paul Enriquez
• Equi Care
• Charlyn May Erasquin
• Erick N Cuenca, DMD, Inc (Brightnow Dental Hayward)
• Ione Erickson
• Jo-an Esberto
• Melvin S Esberto
• Ariana Escobar
• Hallie Kate Escobero
• Angie Escorcia

• Oral and Maxillofacial Surgery (Dentist) in Hayward, CA
• Providers in Hayward, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.