Bethany R Nielsen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D0615 Issued in SD

Practice address

101 Merrill Ave, Box 1010
North Sioux City, SD 57049

Phone

(605) 232-8802

Fax

(605) 232-0973

NPI assigned

Oct 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265514681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 DAKOTA DUNES BLVD",
            "address_2": "APT #108",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495340",
            "telephone_number": "605-422-1413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MERRILL AVE, BOX 1010",
            "city": "NORTH SIOUX CITY",
            "state": "SD",
            "postal_code": "57049",
            "telephone_number": "605-232-8802",
            "fax_number": "605-232-0973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "BETHANY",
        "middle_name": "R",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "D0615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46044478613",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0722009",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46044478600",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marchetti RDS Health PLLC
• Ida Lourdes Mazza, MD
• Mackenzie E McLean, DPT
• Helen E Moss, LMT
• Nationxpress
• North Sioux Chiropractic Clinic, Inc.
• North Sioux Dental Clinic
• Michael O'Neal
• Michael Oberle, DO
• Outpost Optical Inc

• General Practice Dentistry in North Sioux City, SD
• Providers in North Sioux City, 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 Jul 8, 2007; 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.