Provider Demographics
NPI:1538588926
Name:BATES, ERIN (DDS)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:BATES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:DREW
Other - Last Name:GRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1025 N. TIOGA ST
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850
Mailing Address - Country:US
Mailing Address - Phone:607-272-4331
Mailing Address - Fax:
Practice Address - Street 1:1025 N. TIOGA ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850
Practice Address - Country:US
Practice Address - Phone:607-272-4331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-14
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014019548122300000X
CO204301122300000X
390200000X
NY061698122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program