Jake Ericksen, DDS

Dentist · Bellevue, WA

Individual Active NPI

NPI number 1023683398

Practice location

5611 119TH Ave SE Ste 2
Bellevue, WA 98006-3799
Phone
(425) 746-6554

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NPI record

NPI
1023683398
Entity type
Individual (Type 1)
Enumeration date
May 20, 2021
Last updated
July 8, 2021
Certified
July 8, 2021
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X DE61166100 WA
Student in an Organized Health Care Education/Training Program 390200000X — —

Mailing address

1800 Eastlake Ave E Apt 301
Seattle, WA 98102-3787

About Dr. Ericksen

Jake Ericksen, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 5611 119TH Ave SE Ste 2, Bellevue, WA 98006-3799. The NPI number 1023683398 was assigned on May 20, 2021 and the record was last updated on July 8, 2021.

Dr. Ericksen lists a license in the registry: #DE61166100 (WA) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jake Ericksen, DDS?

The NPI number is 1023683398.

What is the phone number of Dr. Ericksen?

The phone number listed for the practice location is (425) 746-6554.

Where is Dr. Ericksen located?

5611 119TH Ave SE Ste 2, Bellevue, WA 98006-3799.

What is the taxonomy code for Dr. Ericksen?

The primary taxonomy code is 122300000X – Dentist; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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