Provider Demographics
NPI:1073910592
Name:KING, ERIKA (DDS)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 SEBASTIAN BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-4345
Mailing Address - Country:US
Mailing Address - Phone:404-895-1434
Mailing Address - Fax:
Practice Address - Street 1:621 SEBASTIAN BLVD STE C
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-4345
Practice Address - Country:US
Practice Address - Phone:404-895-1434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-26
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN210981223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry