DR. MARK SCOTT ERICSON DDS
NPI 1952374761
Dentist - Oral and Maxillofacial Surgery in Hayward, CA

Q: What is Mark Ericson's NPI number?

The NPI number for Mark Ericson is 1952374761. It was assigned to this individual provider in the NPPES registry on February 10, 2006.

Q: What is Mark Ericson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Q: Is Mark Ericson enrolled in Medicare?

No. Mark Ericson has opted out of Medicare through February 20, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Mark Ericson was last updated on April 4, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 10, 2006Opted out of Medicare · through Feb 20, 2027

1320 APPLE AVE STE 104, HAYWARD, CA 94541(360) 870-9097(510) 582-8147 Get Directions Write a Review

NPPES record last updated: April 4, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Mark Scott Ericson Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARK SCOTT ERICSON DDS (NPI 1952374761) is an individual oral and maxillofacial surgery provider in Hayward, California, licensed in California (60084) and active in the NPI registry since February 2006. He has opted out of Medicare through February 20, 2027.

NPPES Registry Identity

NPI1952374761

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NameDR. MARK SCOTT ERICSONCredential: DDS

Location Address1320 APPLE AVE STE 104Hayward, CA 94541-1552

Mailing Address1320 Apple Ave Ste 104Hayward, CA 94541-1552 · (360) 870-9097 · Fax (510) 582-8147

Phone(360) 870-9097

Fax(510) 582-8147

Sole ProprietorYes

Enumeration DateFebruary 10, 2006

Last NPPES UpdateApril 4, 2012

✔ NPI 1952374761 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

Licenses✔ Licensed in CA · 60084✔ Licensed in TX · 23691✔ Licensed in NJ · 22DI02230300

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

1320 APPLE AVE STE 104, Hayward, CA 94541

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Mark Scott Ericson Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 20, 2025 through February 20, 2027.

Opt-Out Effective DateFebruary 20, 2025

Opt-Out In Effect ThroughFebruary 20, 2027Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Ericson's NPI number?

The NPI number for Mark Ericson is 1952374761. It was assigned to this individual provider in the NPPES registry on February 10, 2006.

Where is Mark Ericson located?

Mark Ericson practices at 1320 Apple Ave Ste 104, Hayward, CA 94541. The listed phone number is (360) 870-9097.

What is Mark Ericson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Mark Ericson enrolled in Medicare?

No. Mark Ericson has opted out of Medicare through February 20, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Mark Ericson was last updated on April 4, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.