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NORTHERN PLAINS ORAL AND MAXILLOFACIAL SURGERY LLC NPI 1487718565


NPI Information

NPI: 1487718565
Provider Name: NORTHERN PLAINS ORAL AND MAXILLOFACIAL SURGERY LLC
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
820 1ST AVE SE
SUITE 400
ABERDEEN, SD
ZIP 57401
Phone: (605) 225-9362
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NORTHERN PLAINS ORAL AND MAXILLOFACIAL SURGERY LLC is an oral and maxillofacial surgery dentist in Aberdeen, SD. The provider is 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. NORTHERN PLAINS ORAL AND MAXILLOFACIAL SURGERY LLC NPI is 1487718565. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

820 1ST AVE SE
SUITE 400
ABERDEEN, SD
ZIP 57401-601
Phone: (605) 225-9362
Fax: (605) 229-7317

The provider's authorized official is Carl M Kimbler .
The authorized official title is Owner and has the following contact phone number (605) 225-9362.

The enumeration date for this NPI number is 12/21/2006 and was last updated on 3/25/2013.


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
11223S0112XDentistOral and Maxillofacial SurgerySD4237SOUTH DAKOTANo
21223S0112XDentistOral and Maxillofacial SurgeryM862SOUTH DAKOTAYes

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
10006084OTHERSOUTH DAKOTABLUE CROSS
26084MEDICARE ID-TYPE UNSPECIFIEDSOUTH DAKOTA
341240MEDICAIDNORTH DAKOTA
48000400MEDICAIDSOUTH DAKOTA
5U67637MEDICARE UPIN

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: 4/28/2024

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