Individual provider Active NPI

Derik Hoerner, D.D.S.

  • Dentist
  • Bismarck, ND
National Provider Identifier
1407082241
Registry record updated Jun 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2057 Issued in ND
Practice address
1004 S 7TH St
Bismarck, ND 58504-6531
Phone
(701) 258-5220
NPI assigned
Jun 8, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2057 ND Primary

Addresses

Primary practice location

1004 S 7TH St
Bismarck, ND 58504-6531

Mailing address

1004 S 7TH St
Bismarck, ND 58504-6531
Phone (701) 258-5220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150908002384 ND Order and Referring Only - DentistPractitioner - Dentist 4880900711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2057NDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bismarck Advanced Dental and Implants GP Dentist Current Accepting new patients

Locations

1004 S 7th St
Bismarck, ND 58504
Phone (701) 258-5220

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244419200000",
    "number": "1407082241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 S 7TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585046531",
            "telephone_number": "701-258-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 S 7TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585046531",
            "telephone_number": "701-258-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOERNER",
        "first_name": "DERIK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-08",
        "last_updated": "2009-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ND",
            "license": "2057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.