NPIMap

Organization Active NPI

Dr Sven Erickson D D S P C

Doing business as Modern Dentistry Associates

  • Dentist
  • Saint Joseph, MI
National Provider Identifier
1972872851
Registry record updated Mar 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901015318 Issued in MI
Legal business name
DR SVEN ERICKSON D D S P C
Doing business as
Modern Dentistry Associates
Practice address
3915 Stonegate Park
Saint Joseph, MI 49085-9130
Phone
(269) 429-1515
Fax
(269) 429-1538
NPI assigned
Dec 21, 2011
Last updated
Mar 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2012

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

Authorized official

Name
Dr. Sven Alan Erickson, DDSNPI 1568683860
Title
President
Phone
(269) 429-1515

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
Customized Equipment (DME) 332BC3200X
Dentist 122300000X 2901015318 MI Primary

Addresses

Primary practice location

3915 Stonegate Park
Saint Joseph, MI 49085-9130

Mailing address

3915 Stonegate Park
Saint Joseph, MI 49085-9130
Phone (269) 429-1515

Other names 1

  • MODERN DENTISTRY ASSOCIATES Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1324425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332201600000",
    "number": "1972872851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 STONEGATE PARK",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859130",
            "telephone_number": "269-429-1515",
            "fax_number": "269-429-1538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 STONEGATE PARK",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859130",
            "telephone_number": "269-429-1515",
            "fax_number": "269-429-1538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR SVEN ERICKSON D D S P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-21",
        "last_updated": "2012-03-20",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "SVEN",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-429-1515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901015318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MODERN DENTISTRY ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Joseph, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; 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.