Travis Bjordahl, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D630 Issued in SD

Practice address

1203 E 4TH Ave
Suite 103
Milbank, SD 57252-1562

Phone

(605) 432-5032

NPI assigned

Jun 13, 2016

Last updated

Jun 13, 2016By the provider in NPPES

Sex

Male

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 SD

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

Locations

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.

• Travis J. Bjordahl, DDS, PLLC

  dba Bjordahl Dental Care

  • Dental Clinic/Center
  • Milbank, SD
  • NPI 1518425552
  NPD Authorized official
• Mark a Bierschbach D.D.S., P.C.

  • General Practice Dentistry
  • Milbank, SD
  • NPI 1063593275
  NPD (past)

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1497104228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 E 4TH AVE STE 103",
            "address_2": "P.O. BOX 592",
            "city": "MILBANK",
            "state": "SD",
            "postal_code": "572521558",
            "telephone_number": "605-432-5032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 E 4TH AVE",
            "address_2": "SUITE 103",
            "city": "MILBANK",
            "state": "SD",
            "postal_code": "572521562",
            "telephone_number": "605-432-5032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BJORDAHL",
        "first_name": "TRAVIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-13",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "D630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Bailey, PH.D.
• Alan David Bergquist, DC
• Bien Pharmacy Inc (Bien Pharmacy)
• Mark Bierschbach, DDS
• Kevin L Bjordahl, M.D.
• Kristy Nichole Boettcher, PTA
• Mary G Bray
• Wendy Kristine Breske, LCSW-PIP
• Bryan C. Johnson, DDS, PC
• Leshea Marie Buttke, DO

• General Practice Dentistry in Milbank, SD
• Providers in Milbank, SD by specialty
• General Practice Dentistry in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; 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.