Healthcare Provider Details

I. General information

NPI: 1346467206
Provider Name (Legal Business Name): JOSHUA ERICKSON DDS MSD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 04/05/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9334 GRAND CORDERA PKWY
COLORADO SPRINGS CO
80924-7000
US

IV. Provider business mailing address

9334 GRAND CORDERA PKWY
COLORADO SPRINGS CO
80924-7000
US

V. Phone/Fax

Practice location:
  • Phone: 719-282-6666
  • Fax: 719-203-5477
Mailing address:
  • Phone: 719-439-9476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDEN 9665
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDEN 9665
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: