Jamie W Steidl, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

1967 Issued in ND

Practice address

915 37TH Ave S
Moorhead, MN 56560

Phone

(218) 236-9319

Fax

(218) 236-9320

NPI assigned

Nov 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Steidl Family Dentistry PC

  • Dental Clinic/Center
  • Moorhead, MN
  • NPI 1700104072
  NPD (past) Authorized official

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1437228566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 37TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565606148",
            "telephone_number": "218-236-9319",
            "fax_number": "218-236-9320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 37TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "56560",
            "telephone_number": "218-236-9319",
            "fax_number": "218-236-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEIDL",
        "first_name": "JAMIE",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "12067",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ND",
            "license": "1967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "498960100",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41354",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Lea Staszko, LPCC, LPCC-S
• Robert Dennis Staton, M.D.
• Sharon Staton
• Abby Lynn Steer, MSW, LICSW
• Steidl Family Dentistry PC
• Emil B Steinke, MD
• Miranda Renae Skancke Steinke, LGSW
• Rowland George Stetson, LADC,
• Emily Christine Stevenson
• Sydney Stewart

• Dentist in Moorhead, MN
• Providers in Moorhead, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; 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.