Individual provider Active NPI

Jeremy J Messer, DMD

  • General Practice Dentistry
  • Williston, ND
National Provider Identifier
1174889273
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2113 Issued in ND
Practice address
2224 1St Ave W
Williston, ND 58801-6286
Phone
(701) 774-0404
Fax
(701) 774-9047
NPI assigned
Apr 3, 2012
Last updated
May 12, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2113 ND Primary

Addresses

Primary practice location

2224 1St Ave W
Williston, ND 58801-6286

Mailing address

2224 1St Ave W
Williston, ND 58801-6286
Phone (701) 774-0404

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
2113NDMDGeneral Practice Dentistry

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1174889273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2224 1ST AVE W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588016286",
            "telephone_number": "701-774-0404",
            "fax_number": "701-774-9047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2224 1ST AVE W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588016286",
            "telephone_number": "701-774-0404",
            "fax_number": "701-774-9047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESSER",
        "first_name": "JEREMY",
        "middle_name": "J",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-03",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "2113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.

Verify at the official NPI Registry.