Destination Dental Professionals II

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

M-490 Issued in SD

Legal business name

DESTINATION DENTAL PROFESSIONALS II

Doing business as

DBA/ Destination Dentistry

Practice address

141 N 5TH St
Custer, SD 57730-1528

Phone

(605) 673-2011

NPI assigned

Feb 10, 2007

Last updated

Aug 2, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Diana Latinow, DDS

Title

Dentist / Owner

Phone

(605) 673-2011

Specialties & licenses 1

Addresses

Other names 1

• DBA/ Destination Dentistry Doing business as

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

{
    "created_epoch": "1171065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533168000000",
    "number": "1043351018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 N 5TH ST",
            "city": "CUSTER",
            "state": "SD",
            "postal_code": "577301528",
            "telephone_number": "605-673-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 N 5TH ST",
            "city": "CUSTER",
            "state": "SD",
            "postal_code": "577301528",
            "telephone_number": "605-673-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINATION DENTAL PROFESSIONALS II",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-10",
        "last_updated": "2018-08-02",
        "status": "A",
        "authorized_official_last_name": "LATINOW",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "DENTIST / OWNER",
        "authorized_official_telephone_number": "605-673-2011",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "M-490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA/ Destination Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Custer Community Pharmacy LLC
• Custer School District
• Custer School District 16-1
• Daniel L Custis, DDS
• Natalie Cutler, MPT
• Joy M Falkenburg, MD
• Catherine Renee Franco, DDS
• Terry M Graber, MD
• Margaret Gukeisen, RPT
• Nicole Habbe

• General Practice Dentistry in Custer, SD
• Providers in Custer, SD by specialty
• General Practice Dentistry in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; 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.