NORTH SIOUX DENTAL CLINIC NPI 1912048687

NPI Information

NPI: 1912048687
Provider Name: NORTH SIOUX DENTAL CLINIC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 43D2166684

Address:
101 MERRILL AVE.
NORTH SIOUX CITY, SD
ZIP 57049
Phone: (605) 232-8802
Get Directions

NORTH SIOUX DENTAL CLINIC is a general practice dentist in North Sioux City, SD. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. NORTH SIOUX DENTAL CLINIC NPI is 1912048687. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

101 MERRILL AVE.
NORTH SIOUX CITY, SD
ZIP 57049
Phone: (605) 232-8802
Fax: (605) 232-0973

The provider's authorized official is Donald B Cork .
The authorized official title is General Dentist and has the following contact phone number (605) 232-8802.

The CLIA number assigned to this NPI record is 43D2166684 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/8/2007 and was last updated on 8/22/2020.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	M847	SOUTH DAKOTA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0722009	MEDICAID	IOWA
2	0989517	MEDICAID	IOWA

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: 5/5/2024

NPI Synchronization or Removal

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