Mark Allan Hildahl, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1573 Issued in ND

Practice address

1300 37TH Ave SW
Minot, ND 58701-7240

Phone

(701) 852-5595

Fax

(701) 852-2669

NPI assigned

May 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Souris Valley Dental Group

  • General Practice Dentistry
  • Minot, ND
  • NPI 1861497430
  NPD (past) Authorized official

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265645766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 37TH AVE SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "58701",
            "telephone_number": "701-852-5595",
            "fax_number": "701-852-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 37TH AVE SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587017240",
            "telephone_number": "701-852-5595",
            "fax_number": "701-852-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILDAHL",
        "first_name": "MARK",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "1573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marci A Hettich, O.T.R.L.
• Katie Heupel, LPCC
• Danielle Rae Hicks
• Emily Hieb
• Heather Hiebert
• Hill Eye Clinic PC
• Darren Christian Hill, MD
• Kelly Hill
• Tetra Hill
• Chantel K Hillestad, FNP-C

• General Practice Dentistry in Minot, ND
• Providers in Minot, ND by specialty
• General Practice Dentistry in North 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.