Individual provider Active NPI

Thomas Paul Welk, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bismarck, ND
National Provider Identifier
1124548367
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
2371 Issued in ND
Practice address
1165 W Turnpike Ave
Bismarck, ND 58501-8115
Phone
(701) 751-1981
NPI assigned
Jun 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X RES-30498 IA
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 2371 ND Primary

Addresses

Primary practice location

1165 W Turnpike Ave
Bismarck, ND 58501-8115

Mailing address

1165 W Turnpike Ave
Bismarck, ND 58501-8115
Phone (701) 202-0094

Other identifiers 1

IdentifierTypeStateIssuer
1459055MedicaidND

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL info@hollevoetorthodontics.com Direct

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RES-30498IAMDOrthodontics and Dentofacial Orthopedic Dentist
2371NDMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
The Aligner Studio Orthodontics and Dentofacial Orthopedics Current Accepting new patients
Hollevoet Orthodontics Orthodontics and Dentofacial Orthopedics CurrentSince Sep 29, 2019 Accepting new patients

Locations

1165 W Turnpike Ave
Bismarck, ND 58501
Phone (612) 625-6444

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": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1124548367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 W TURNPIKE AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585018115",
            "telephone_number": "701-202-0094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 W TURNPIKE AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585018115",
            "telephone_number": "701-751-1981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELK",
        "first_name": "THOMAS",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-20",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IA",
            "license": "RES-30498",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "ND",
            "license": "2371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1459055",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "info@hollevoetorthodontics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "1165 W Turnpike Ave",
            "city": "Bismarck",
            "state": "ND",
            "country_code": "US",
            "postal_code": "585018115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.