Hillary Van Dyke

Individual provider Active NPI General Practice Dentistry · Brookings, SD

NPI 1144755166 · NPPES record last updated Jul 14, 2017

Key facts

NPI
1144755166
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
D1160 (SD)
Practice address
2220 Yorkshire Dr
Brookings, SD 57006-2442
Phone
(605) 697-6262
Fax
(605) 692-1521
NPI assigned
Apr 27, 2017
Sex
Female
Sole proprietor
Yes

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.

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
D1160SDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Prouty Brookings Dental, LLC Past Accepting new patients
Brookings Embrace Dental Clinic LLC General Practice Past
since Sep 20, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D1160 SD Yes

Addresses

Primary practice location

2220 Yorkshire Dr
Brookings, SD 57006-2442

Mailing address

2220 Yorkshire Dr
Brookings, SD 57006-2442
Phone (605) 697-6262

Other providers in Brookings, SD

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

Sources for this page

Verify at the official NPI Registry.