NPIMap

Organization Active NPI

South Western Dental

  • General Practice Dentistry
  • Sioux Falls, SD
National Provider Identifier
1326136607
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SOUTH WESTERN DENTAL
Practice address
5201 S Western Ave
Sioux Falls, SD 57108-5004
Phone
(605) 339-2200
Fax
(605) 334-5530
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Thomas James Weisbecker, DDSNPI 1245328533
Title
President
Phone
(605) 339-2200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

5201 S Western Ave
Sioux Falls, SD 57108-5004

Mailing address

5201 S Western Ave
Sioux Falls, SD 57108-5004
Phone (605) 339-2200

Other identifiers 3

IdentifierTypeStateIssuer
0937011MedicaidIA
7803400MedicaidSD
926228MedicaidMN

National Provider Directory

National Provider Directory

Locations

5201 S Western Ave
Sioux Falls, SD 57108
Phone (605) 339-2200

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326136607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 S WESTERN AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571085004",
            "telephone_number": "605-339-2200",
            "fax_number": "605-334-5530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 S WESTERN AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571085004",
            "telephone_number": "605-339-2200",
            "fax_number": "605-334-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH WESTERN DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEISBECKER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "605-339-2200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0937011",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7803400",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "926228",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.