Prairie Ridge Endodontics LLC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

PRAIRIE RIDGE ENDODONTICS LLC

Practice address

600 4TH St NE Ste 101
Watertown, SD 57201-1898

Phone

(605) 878-0180

Fax

(605) 878-0181

NPI assigned

Oct 27, 2022

Last updated

Oct 27, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sara Katherine Evans

Title

Office Manager

Phone

(605) 878-0180

Specialties & licenses 1

Addresses

Locations

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.

• Michael John Hawley, DDS MS

  • Dentist
  • Watertown, SD
  • NPI 1891775904
  NPD (past)

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

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666828800000",
    "number": "1336866557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 4TH ST NE STE 101",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011898",
            "telephone_number": "605-878-0180",
            "fax_number": "605-878-0181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 4TH ST NE STE 101",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011898",
            "telephone_number": "605-878-0180",
            "fax_number": "605-878-0181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 N 4th St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Aberdeen",
            "state": "SD",
            "postal_code": "574012727",
            "country_code": "US",
            "telephone_number": "605-878-0180",
            "fax_number": "605-226-2790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRAIRIE RIDGE ENDODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-27",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "KATHERINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "605-878-0180"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prairie Lakes Health Care System Inc (Prairie Lakes Peritoneal Dialysis)
• Prairie Lakes Health Care System Inc (Sanford Watertown Medical Center)
• Prairie Lakes Health Care System Inc (Sanford Watertown Specialty Clinic)
• Prairie Lakes Home Connections
• Prairie Ridge Endodontics
• Precision Vision (pearle vision)
• Preventative Dental LLC
• Brittiany Pribbenow
• Professional Hearing Services Inc.
• Progressive Therapy LLC

• Endodontics in Watertown, SD
• Providers in Watertown, SD by specialty
• Endodontics in South Dakota

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