NPIMap

Organization Active NPI

Michael R Juba DDS Inc

  • Dentist
  • Brandon, SD
National Provider Identifier
1386198356
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
M592 Issued in SD
Legal business name
MICHAEL R JUBA DDS INC
Practice address
704 N Splitrock Blvd
Brandon, SD 57005-2053
Phone
(605) 582-7102
Fax
(605) 582-7109
NPI assigned
Aug 8, 2016
Last updated
Aug 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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

Authorized official

Name
Dr. Michael Juba, DDSNPI 1124161773
Title
Owner/Dentist
Phone
(605) 582-7102

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X M592 SD Primary

Addresses

Primary practice location

704 N Splitrock Blvd
Brandon, SD 57005-2053

Mailing address

704 N Splitrock Blvd
PO Box 624
Brandon, SD 57005-2053
Phone (605) 582-7102

National Provider Directory

National Provider Directory

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": "1470614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470614400000",
    "number": "1386198356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 N SPLITROCK BLVD",
            "address_2": "PO BOX 624",
            "city": "BRANDON",
            "state": "SD",
            "postal_code": "570052053",
            "telephone_number": "605-582-7102",
            "fax_number": "605-582-7109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 N SPLITROCK BLVD",
            "city": "BRANDON",
            "state": "SD",
            "postal_code": "570052053",
            "telephone_number": "605-582-7102",
            "fax_number": "605-582-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL R JUBA DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-08",
        "last_updated": "2016-08-08",
        "status": "A",
        "authorized_official_last_name": "JUBA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "605-582-7102",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "SD",
            "license": "M592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; 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.