Amanda Jean Schwaderer, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D0938 Issued in SD

Practice address

116 E Main St
Beresford, SD 57004-1819

Phone

(605) 763-5035

Fax

(605) 763-8036

NPI assigned

Jun 30, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shawd Neighborhood Dental Clinic Beresford P.C.

  • General Practice Dentistry
  • Beresford, SD
  • NPI 1467763995
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1033420567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 E MAIN ST",
            "city": "BERESFORD",
            "state": "SD",
            "postal_code": "570041819",
            "telephone_number": "605-763-5035",
            "fax_number": "605-763-8036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 E MAIN ST",
            "city": "BERESFORD",
            "state": "SD",
            "postal_code": "570041819",
            "telephone_number": "605-763-5035",
            "fax_number": "605-763-8036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWADERER",
        "first_name": "AMANDA",
        "middle_name": "JEAN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SD",
            "license": "D0938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell G Oehlerts, DPT
• Kayla Pardy, PHD
• Sharon Petrik
• Sanford Health Network
• Sanford Health Network
• Shawd Neighborhood Dental Clinic Beresford P.C.
• Sioux Valley Clinic
• Southeast Area Cooperative
• Southeast Area Cooperative
• Nicole Rose Spaniol, LPN

• Dentist in Beresford, SD
• Providers in Beresford, SD by specialty
• Dentist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.