Mark C Berdahl, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

M687 Issued in SD

Practice address

6301 S Minnesota Ave
Suite 100
Sioux Falls, SD 57108-2528

Phone

(605) 332-4751

Fax

(605) 332-5113

NPI assigned

Jul 4, 2006

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Aug 9, 2019 through Aug 9, 2027

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.

• Family, Cosmetic & Implant Dentistry, DRS. Berdahl & Feiock, P.C.

  • Dentist
  • Sioux Falls, SD
  • NPI 1497956304
  NPD (past) Authorized official
• Boone Family Chiropractic P.C.

  • Chiropractor
  • Viborg, SD
  • NPI 1871523555
  NPD (past)
• Sensational Smiles Dentistry Subsidiary

  • Dental Clinic/Center
  • Sioux Falls, SD
  • NPI 1083383749
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275563264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 S MINNESOTA AVE",
            "address_2": "SUITE 100",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082528",
            "telephone_number": "605-332-4751",
            "fax_number": "605-332-5113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 S MINNESOTA AVE",
            "address_2": "SUITE 100",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082528",
            "telephone_number": "605-332-4751",
            "fax_number": "605-332-5113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERDAHL",
        "first_name": "MARK",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "M687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret A. Benson, MD
• Morgan K Benson
• Jacob Lee Bentson
• Joan Louise Benz, PHD, MSW, CSW-PIP
• John Palmer Berdahl, M.D.
• Jason Bereded
• Danica Mae Berens, RN
• Hannah Berens
• Patti J Berg-Poppe, MA, MPT
• Aaron David Berg, M.D.

• General Practice Dentistry in Sioux Falls, SD
• Providers in Sioux Falls, 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.