Active NPI
William J Reardon, D.D.S.
- Dentist
- Yankton, SD
National Provider Identifier
1164432258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- M824
- Practice address
- 1100 Broadway Ave
Suite 1
Yankton, SD 57078-2927 - Phone
- (605) 668-2273
- Fax
- (605) 668-2273
- NPI assigned
- Aug 9, 2006
- 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 | M824 | SD | Primary |
Addresses
Primary practice location
1100 Broadway Ave
Suite 1
Yankton, SD 57078-2927
Mailing address
1100 Broadway Ave
Suite 1
Yankton, SD 57078-2927
Phone (605) 668-2273
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
| License | State | Type | Specialty |
|---|---|---|---|
| M824 | SD | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397606400000",
"number": "1164432258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 BROADWAY AVE",
"address_2": "SUITE 1",
"city": "YANKTON",
"state": "SD",
"postal_code": "570782927",
"telephone_number": "605-668-2273",
"fax_number": "605-668-2273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 BROADWAY AVE",
"address_2": "SUITE 1",
"city": "YANKTON",
"state": "SD",
"postal_code": "570782927",
"telephone_number": "605-668-2273",
"fax_number": "605-668-2273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REARDON",
"first_name": "WILLIAM",
"middle_name": "J",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-09",
"last_updated": "2014-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SD",
"license": "M824",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yankton, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.