Individual provider Active NPI

Scott Velgersdyk, DDS

  • Dentist
  • Sioux Falls, SD
National Provider Identifier
1114146479
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
M739 Issued in SD
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
7806170MedicaidSD

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190605001714 SD Order and Referring Only - DentistPractitioner - Dentist 6103159256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
M739SDMDDentist

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.