Wiseman & Tidstrom Dental Management, LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

WISEMAN & TIDSTROM DENTAL MANAGEMENT, LLC

Doing business as

Prairie Skies Family Dentristry

Practice address

420 Front Street
Brookings, SD 57006

Phone

(605) 692-9555

Fax

(605) 692-0967

NPI assigned

Sep 30, 2015

Organization subpart

Yes

Parent organization

WISEMAN & TIDSTROM DENTAL MANAGEMENT, LLCAs reported in NPPES

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

Authorized official

Name

Erik Wiseman, D.D.S.

Title

Dentist / Owner

Phone

(605) 692-9555

Specialties & licenses 2

Addresses

Other names 1

• Prairie Skies Family Dentristry Doing business as

Part of

Wiseman Tidstrom Dental Management LLC

Locations

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488412800000",
    "number": "1427428614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 FRONT STREET",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "57006",
            "telephone_number": "605-692-9555",
            "fax_number": "605-692-0967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 FRONT STREET",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "57006",
            "telephone_number": "605-692-9555",
            "fax_number": "605-692-0967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISEMAN & TIDSTROM DENTAL MANAGEMENT, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WISEMAN & TIDSTROM DENTAL MANAGEMENT, LLC",
        "enumeration_date": "2015-09-30",
        "last_updated": "2017-03-02",
        "status": "A",
        "authorized_official_last_name": "WISEMAN",
        "authorized_official_first_name": "ERIK",
        "authorized_official_title_or_position": "DENTIST / OWNER",
        "authorized_official_telephone_number": "605-692-9555",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "SD",
            "license": "D0624",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prairie Skies Family Dentristry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hailey Arlene Will, PHARM.D.
• Willert Enterprises PC (Willert Wellness & Chiropractic)
• Dennis Jay Willert, DC
• Jennifer Elaine Williamson, M.D.
• Brooke Madison Wilmesherr, CCC-SLP
• Erik Mark Treman Wiseman, DDS
• Bradley D. Woldt, PH.D.
• Blake Wooten
• Wyatt Nash-Keller OD Prof LLC
• Christina Yackley, DC

• Dentist in Brookings, SD
• Providers in Brookings, SD by specialty
• Dentist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; 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.