Active NPI
James Theodore Podrebarac, DDS
- Dentist
- Bismarck, ND
National Provider Identifier
1023059771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1973
- Practice address
- 3100 Railway Av
Bismarck, ND 58501 - Phone
- (701) 328-6118
- Fax
- (701) 328-6391
- NPI assigned
- Jun 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1973 | ND | Primary |
Addresses
Primary practice location
3100 Railway Av
Bismarck, ND 58501
Mailing address
1258 Eagle Crest Loop
Bismarck, ND 58503-8849
Phone (701) 258-1144
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1973 | ND | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1023059771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1258 EAGLE CREST LOOP",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585038849",
"telephone_number": "701-258-1144",
"fax_number": "701-328-6391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 RAILWAY AV",
"city": "BISMARCK",
"state": "ND",
"postal_code": "58501",
"telephone_number": "701-328-6118",
"fax_number": "701-328-6391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PODREBARAC",
"first_name": "JAMES",
"middle_name": "THEODORE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-10",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "ND",
"license": "1973",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bismarck, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.