Provider Demographics
NPI:1376105361
Name:TREEHOUSE KIDS DENTIST
Entity Type:Organization
Organization Name:TREEHOUSE KIDS DENTIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:ESTEP
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:541-264-0211
Mailing Address - Street 1:3960 STERLING WOODS DR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-7209
Mailing Address - Country:US
Mailing Address - Phone:541-264-0211
Mailing Address - Fax:
Practice Address - Street 1:1611 J ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-4252
Practice Address - Country:US
Practice Address - Phone:541-515-6631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1811204233Medicaid