Derik Hoerner, DDS, PC

Primary specialty

DentistTaxonomy code 122300000X

License

2057 Issued in ND

Legal business name

DERIK HOERNER, DDS, PC

Practice address

1004 S. 7TH Street
Bismarck, ND 58504-6531

Phone

(701) 390-1920

Fax

(701) 255-4055

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Derik Hoerner, D.D.S

Title

Dentist

Phone

(701) 955-5111

Specialties & licenses 3

Addresses

Other identifiers 9

Other names 1

• Bismarck Advanced Dental and Implants Other name

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591574400000",
    "number": "1043321334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 S. 7TH STREET",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585046531",
            "telephone_number": "701-390-1920",
            "fax_number": "701-255-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 S. 7TH STREET",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585046531",
            "telephone_number": "701-390-1920",
            "fax_number": "701-255-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERIK HOERNER, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A",
        "authorized_official_last_name": "HOERNER",
        "authorized_official_first_name": "DERIK",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "701-955-5111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "ND",
            "license": "2057",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "1387",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "1427",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DENTAL LICENSE #",
            "identifier": "1427",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40424",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41463",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NDBOE NUMBER",
            "identifier": "2030",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40644",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DENTAL #",
            "identifier": "1387",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NDBOE NUMBER",
            "identifier": "2057",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40642",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41498",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bismarck Advanced Dental and Implants",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bismarck Advanced Dental and Implants",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Bismarck Advanced Dental and Implants",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Khalin F Dendy, MD
• Denise Forte-Pathroff M.D., P.C.
• Briana Denning, LBSW
• Dennis D Sailer DC
• Jordan Jeanette Deraney, MD
• Derosier Chiropractic Clinic, P.C.
• Matthew Richard Derosier, D.C.
• Nayan K Desai, MD
• Jade A Desmidt, DDS
• Eusebio Chiong Desuyo, M.D.

• Dentist in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Dentist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.