Bismarck State College

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

BISMARCK STATE COLLEGE

Practice address

210 W Century Ave
Bismarck, ND 58503-1494

Phone

(701) 224-2644

NPI assigned

Dec 2, 2024

Organization subpart

No

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

Authorized official

Name

Heidi Kainoa, RDH

Title

Dental Clinic Manager

Phone

(701) 224-2644

Specialties & licenses 1

Addresses

Other names 1

• Mystics Smiles Other name

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

{
    "created_epoch": "1733097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1285450544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W CENTURY AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585031494",
            "telephone_number": "701-224-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W CENTURY AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585031494",
            "telephone_number": "701-224-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BISMARCK STATE COLLEGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-02",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "KAINOA",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_title_or_position": "DENTAL CLINIC MANAGER",
        "authorized_official_telephone_number": "701-224-2644",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mystics Smiles",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Bismarck Public Schools Care Coordination
• Bismarck Public Schools Early Intervention
• Bismarck Radiology Associates PC
• Bismarck Sinus Center
• Bismarck Sports and Spine, PLLC
• Bismarck Surgical Associates LLC
• Bismarck Surgical Associates, LLC
• Bismarck Transportation Services
• Kaitlin Bitterman, LBSW
• Cheryle K Bitz, MSN, ARNP, GNP-BC

• Pediatric Dentistry in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Pediatric Dentistry in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.