Active NPI
Erikson Karacheban
- General Practice Dentistry
- Deland, FL
National Provider Identifier
1992441117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 390200000X
- Practice address
- 250 E International Speedway Blvd
Deland, FL 32724-2340 - Phone
- (386) 626-3296
- NPI assigned
- May 10, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 390200000X | FL | Primary |
Addresses
Primary practice location
250 E International Speedway Blvd
Deland, FL 32724-2340
Mailing address
1105 SW 66TH Ave Apt 3302
Portland, OR 97225-6025
Phone (503) 881-9361
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Aug 15, 2024 through Aug 15, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 390200000X | FL | MD | Vascular & Interventional Radiology Physician |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652140800000",
"number": "1992441117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1105 SW 66TH AVE APT 3302",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972256025",
"telephone_number": "503-881-9361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 E INTERNATIONAL SPEEDWAY BLVD",
"city": "DELAND",
"state": "FL",
"postal_code": "327242340",
"telephone_number": "386-626-3296"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KARACHEBAN",
"first_name": "ERIKSON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-10",
"last_updated": "2022-05-10",
"certification_date": "2022-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "390200000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; 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.