Danielle Mari Demorrow, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

1001578-15 Issued in WI

Practice address

361 N Main St
Watford City, ND 58854-7311

Phone

(701) 842-4474

NPI assigned

Jun 6, 2017

Last updated

Apr 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Legendary Smiles Dental Group

  dba Legendary Smiles

  • Dental Clinic/Center
  • Watford City, ND
  • NPI 1104658079
  NPD
• Columbia St. Mary's Hospital Milwaukee, Inc

  dba Ascension Columbia St Mary's Hospital Milwaukee

  • Multi-Specialty Clinic/Center
  • Mequon, WI
  • NPI 1710928221
  NPD (past)
• Outreach Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1205318102
  NPD (past)

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1437688132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 N MAIN ST",
            "city": "WATFORD CITY",
            "state": "ND",
            "postal_code": "588547311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 N MAIN ST",
            "city": "WATFORD CITY",
            "state": "ND",
            "postal_code": "588547311",
            "telephone_number": "701-842-4474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMORROW",
        "first_name": "DANIELLE",
        "middle_name": "MARI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-06",
        "last_updated": "2021-04-22",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001578-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ilea Charlton
• Crystal Marie Christensen, FNP-C
• Jessica M Comeau, FNP
• Kathleen Danks
• Jeffrey Alan Davis, ATC, LAT
• Jeffrey Alan Dodds, PHARM D
• Grant Edland
• Kellie Ekness
• Empowered Therapy by Tara Lorenz, PLLC
• Amber Briana Eve

• Dentist in Watford City, ND
• Providers in Watford City, ND by specialty
• Dentist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.