Provider Demographics
NPI:1649538703
Name:ERIK P SVANS DDS PC
Entity type:Organization
Organization Name:ERIK P SVANS DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:P
Authorized Official - Last Name:SVANS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-585-6225
Mailing Address - Street 1:7400 E PINNACLE PEAK RD
Mailing Address - Street 2:STE 200
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3592
Mailing Address - Country:US
Mailing Address - Phone:480-219-8760
Mailing Address - Fax:
Practice Address - Street 1:7400 E PINNACLE PEAK RD
Practice Address - Street 2:STE 200
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3592
Practice Address - Country:US
Practice Address - Phone:480-219-8760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-26
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ53021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ6687700001Medicare NSC