MEDICARE: KRISTEN R ERSKIN 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	122300000X	Dentist	2016026477	MO

General Provider Information

NPI Number	:	1235682444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN R ERSKIN DDS

Provider Business Mailing Address
First Line	:	8530 N GREEN HILLS RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64154-1403
Country	:	US
Telephone Number	:	816-587-5555
Fax Number	:

Provider Business Practice Location Address
First Line	:	8530 N GREEN HILLS RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64154-1403
Country	:	US
Telephone Number	:	816-587-5555
Fax Number	:

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

Provider Enumeration Date	:	07/25/2016
Last Update Date	:	12/06/2016

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