Active NPI
Scott Velgersdyk, DDS
- Dentist
- Sioux Falls, SD
National Provider Identifier
1114146479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- M739
- Practice address
- 2200 S Minnesota Ave
Sioux Falls, SD 57105-3748 - Phone
- (605) 334-4121
- NPI assigned
- Apr 25, 2007
- 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 | M739 | SD | Primary |
Addresses
Primary practice location
2200 S Minnesota Ave
Sioux Falls, SD 57105-3748
Mailing address
3608 S Anita Ave
Sioux Falls, SD 57103-7216
Phone (605) 371-4521
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7806170 | Medicaid | SD |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190605001714 | SD | Order and Referring Only - Dentist | 6103159256 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M739 | SD | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| City of Sioux Falls | Past | Accepting new patients | |
| City of Sioux Falls | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Federally Qualified Health Center (FQHC)
- Sioux Falls, SD
- NPI 1609025907
-
- Federally Qualified Health Center (FQHC)
- Sioux Falls, SD
- NPI 1932295888
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114146479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3608 S ANITA AVE",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571037216",
"telephone_number": "605-371-4521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 S MINNESOTA AVE",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571053748",
"telephone_number": "605-334-4121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VELGERSDYK",
"first_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SD",
"license": "M739",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7806170",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sioux Falls, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.