Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jake Ericksen, DDS

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1023683398

Dr. Jake Ericksen, DDS is a Student in an Organized Health Care Education/Training Program in Bellevue, Washington. Licensed in Washington. Registered with an NPI since 2021.

Licensed in
WA
In the registry since
2021
Specialties on file
2
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

5611 119th Ave SE Ste 2
Bellevue, WA 98006-3799
Phone: (425) 746-6554
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence DE61166100 (WA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1023683398
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedMay 20, 2021
Last updated in NPPESJuly 8, 2021
Certification dateJuly 8, 2021
Mailing address1800 Eastlake Ave E Apt 301, Seattle, WA 98102-3787

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