Organization Active NPI

Paul M. Rezich, DDS, PC

  • Dentist
  • Rapid City, SD
National Provider Identifier
1336209808
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PAUL M. REZICH, DDS, PC
Practice address
503 E North St
Rapid City, SD 57701-1462
Phone
(605) 343-2229
Fax
(605) 343-7516
NPI assigned
Dec 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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. Paul M Rezich, DDSNPI 1679591622
Title
Owner President
Phone
(605) 343-2229

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
Dentist 122300000X NU Primary

Addresses

Primary practice location

503 E North St
Rapid City, SD 57701-1462

Mailing address

503 E North St
Rapid City, SD 57701-1462
Phone (605) 343-2229

National Provider Directory

National Provider Directory

Locations

503 E North St
Rapid City, SD 57701
Phone (605) 343-2229

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336209808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 E NORTH ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577011462",
            "telephone_number": "605-343-2229",
            "fax_number": "605-343-7516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 E NORTH ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577011462",
            "telephone_number": "605-343-2229",
            "fax_number": "605-343-7516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL M. REZICH, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REZICH",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "605-343-2229",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, 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.