Edward Douglas Maisey Jr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2463 Issued in ND

Practice address

708 Main St
Williston, ND 58801-5320

Phone

(701) 774-1879

NPI assigned

Jul 27, 2022

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

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• MC Dental Corporation, PC

  dba Maisey Dental Clinic

  • Dental Clinic/Center
  • Williston, ND
  • NPI 1326515776
  NPD (past)
• William H. Maisey Dentist P.C.

  • Dentist
  • Williston, ND
  • NPI 1902096563
  NPD (past)

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

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1306572896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 MAIN ST",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588015320",
            "telephone_number": "701-774-1879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 MAIN ST",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588015320",
            "telephone_number": "701-774-1879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 1st St NW",
            "address_purpose": "LOCATION",
            "city": "Crosby",
            "state": "ND",
            "postal_code": "587303004",
            "country_code": "US",
            "telephone_number": "701-965-4362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAISEY",
        "first_name": "EDWARD",
        "middle_name": "DOUGLAS",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "2463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Lux
• Shelly Lynch
• Jocelynn Maclean
• Emily Marin Madsen, PHARMD
• Kelly Magrum, CNA
• Edward Douglas Maisey, DDS
• William Henry Maisey, DDS
• Michelle Joan Manire
• Charity O Manuels-Onoja
• Hooria Manzoor, MD

• General Practice Dentistry in Williston, ND
• Providers in Williston, 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 27, 2022; 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.