Provider Demographics
NPI:1164234845
Name:ALAN D. ERICKSON, D.D.S., P.S.
Entity type:Organization
Organization Name:ALAN D. ERICKSON, D.D.S., P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:ERICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-330-9959
Mailing Address - Street 1:16410 SMOKEY POINT BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-8415
Mailing Address - Country:US
Mailing Address - Phone:360-322-6934
Mailing Address - Fax:
Practice Address - Street 1:15955 85 NE ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3550
Practice Address - Country:US
Practice Address - Phone:360-322-6934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALAN D ERICKSON DDS PS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies