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ERIC J DIERKS MD DMD NPI 1265432025


NPI Information

NPI: 1265432025
Provider Name: ERIC J DIERKS, MD, DMD
Classification: Oral & Maxillofacial Surgery - 204E00000X
Entity Type: Individual
Organization: HEAD AND NECK SURGICAL ASSOCIATES, PC

PECOS Registration: Yes

Address:
1849 NW KEARNEY ST
PORTLAND, OR
ZIP 97209
Phone: (503) 224-1371
Get Directions

Eric J Dierks, MD, DMD is an oral maxillofacial surgery in Portland, OR with 45 years of experience. The provider is oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. Eric J Dierks, MD, DMD NPI is 1265432025. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE
Graduation Year:1979

The provider's business location address is:

1849 NW KEARNEY ST
PORTLAND, OR
ZIP 97209
Phone: (503) 224-1371
Fax: (503) 224-0722

The NPI 1265432025 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/22/2005 and was last updated on 6/11/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1204E00000XOral & Maxillofacial SurgeryMD16391OREGONYes
2204E00000XOral & Maxillofacial SurgeryD6708OREGONNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1008560MEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.