Serena Whitesell, DDS

Individual provider Active NPI General Practice Dentistry · Parkston, SD

NPI 1104355791 · NPPES record last updated Mar 5, 2024

Key facts

NPI
1104355791
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DDS-09416 (IA)
Practice address
714 W Maple St
Parkston, SD 57366-2313
Phone
(605) 928-3363
NPI assigned
Jun 7, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DDS-09416IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kralik Dental Centers, PC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DDS-09416 IA Yes

Addresses

Primary practice location

714 W Maple St
Parkston, SD 57366-2313

Mailing address

PO Box 785
Parkston, SD 57366-0785
Phone (605) 928-3363

Other practice location 1

1008 E Industrial St
Freeman, SD 57029-8501
Phone (605) 925-4999

Other providers in Parkston, SD

All providers in Parkston, SD · General Practice Dentistry in South Dakota

Sources for this page

Verify at the official NPI Registry.