Isd National Clinic LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ISD NATIONAL CLINIC LLC

Practice address

4320 S Minnesota Ave
Sioux Falls, SD 57105-6747

Phone

(605) 275-2009

Fax

(605) 884-9133

NPI assigned

Dec 28, 2023

Organization subpart

No

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

Authorized official

Name

Brian Prouty, DDS

Title

Owner

Phone

(605) 275-2009

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1703721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703721600000",
    "number": "1114796422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 POMPESKA DR",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572015463",
            "telephone_number": "605-275-2009",
            "fax_number": "605-884-9133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 S MINNESOTA AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571056747",
            "telephone_number": "605-275-2009",
            "fax_number": "605-884-9133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISD NATIONAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-28",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A",
        "authorized_official_last_name": "PROUTY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-275-2009",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Jon Irons, RPH
• Dana Irvine, LCSW, QMHP
• Rebekah Marie Irwin, APRN
• Kaitlyn Sarah Isaacson, CNP
• Kris Michael Isakson, D.C.
• Lenn Island
• Mackenzie Island, RBT
• Vicki L Isler, EDD BCBA-D LBA
• Gabrielle Eileen Iversen, PA-C
• Bradley Eugene Iverson, M.D.

• General Practice Dentistry in Sioux Falls, SD
• Providers in Sioux Falls, 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 Dec 28, 2023; 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.