Provider Demographics
NPI:1649730227
Name:BERHORST, ERIKA A (RDH)
Entity type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:A
Last Name:BERHORST
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:
Other - Last Name:HUSEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1800 COMMUNITY
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MO
Mailing Address - Zip Code:64735-8804
Mailing Address - Country:US
Mailing Address - Phone:608-858-1316
Mailing Address - Fax:
Practice Address - Street 1:1030 WOLFRUM RD
Practice Address - Street 2:
Practice Address - City:WELDON SPRING
Practice Address - State:MO
Practice Address - Zip Code:63304-7795
Practice Address - Country:US
Practice Address - Phone:844-853-8937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO003647124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist