Larry Wayne Erickson, DDS is a medicare enrolled "Dentist - General Practice" provider in St. Anthony, Minnesota. His current practice location is
4001 Stinson Blvd Ne, Suite 414, St. Anthony, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(612) 789-7888.
Larry Wayne Erickson is licensed to practice in Minnesota (license number 8758) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1083683437.
Healthcare Provider's Profile
Full Name | Larry Wayne Erickson |
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Gender | Male |
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Speciality | Dentist - General Practice |
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Location | 4001 Stinson Blvd Ne, St. Anthony, Minnesota |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1083683437
- Provider Enumeration Date: 03/17/2006
- Last Update Date: 12/15/2010
Medicare PECOS Information:
- PECOS PAC ID: 9032404959
- Enrollment ID: I20160817000468
Medical Identifiers
Medical identifiers for Larry Wayne Erickson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1083683437 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 8758 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Larry Wayne Erickson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Larry Wayne Erickson, DDS 4001 Stinson Blvd Ne, Suite 414, St. Anthony, MN 55421 Ph: (612) 789-7888 | Larry Wayne Erickson, DDS 4001 Stinson Blvd Ne, Suite 414, St. Anthony, MN 55421 Ph: (612) 789-7888 |
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