Provider Demographics
NPI:1912099227
Name:ERIKSEN, STEPHEN P (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:P
Last Name:ERIKSEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2021 YGNACIO VALLEY RD
Mailing Address - Street 2:SUITE A2
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3388
Mailing Address - Country:US
Mailing Address - Phone:925-944-1707
Mailing Address - Fax:925-935-1492
Practice Address - Street 1:2021 YGNACIO VALLEY RD
Practice Address - Street 2:SUITE A2
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3388
Practice Address - Country:US
Practice Address - Phone:925-944-1707
Practice Address - Fax:925-935-1492
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA32954122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist