MEDICARE: LARRY WAYNE ERICKSON DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	8758	MN

General Provider Information

NPI Number	:	1083683437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY WAYNE ERICKSON DDS

Provider Business Mailing Address
First Line	:	4001 STINSON BLVD NE
Second Line	:	SUITE 414
City	:	ST. ANTHONY
State	:	MN
Zip	:	55421
Country	:	US
Telephone Number	:	612-789-7888
Fax Number	:	612-789-7889

Provider Business Practice Location Address
First Line	:	4001 STINSON BLVD NE
Second Line	:	SUITE 414
City	:	ST. ANTHONY
State	:	MN
Zip	:	55421
Country	:	US
Telephone Number	:	612-789-7888
Fax Number	:	612-789-7889

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	12/15/2010

Similar Medicare Providers

1003882150 — DR. KAJAL DASGUPTA M.D.
Practice Location Address:

2101 E JEFFERSON ST , KAISER PERMANENTE MEDICARE ENROLLMENT
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-2424
Practice Fax:

1881646115 — MS. MELISSA RYAN STRAUSS P.A.
Practice Location Address:

2101 E JEFFERSON ST , KAISER PERMANENTE MEDICARE ENROLLMENT
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-2424
Practice Fax:

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1447337068 — STEPHANIE GANSCHOW PHARMD
Practice Location Address:

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

1881639730 — CHANDLER PLACE LIMITED PARTNERSHIP
Practice Location Address:

3701 CHANDLER DR NE
ST ANTHONY, MN
55421-4413

Practice Phone: 612-788-7321
Practice Fax: 612-913-5370

1053347179 — SILVER LAKE CLINIC
Practice Location Address:

2600 39TH AVE NE
ST ANTHONY, MN
55421-4372

Practice Phone: 612-706-2900
Practice Fax: 612-706-2901

Directions to “ LARRY WAYNE ERICKSON DDS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.