Individual provider Active NPI

Bruce Dale Wintle, DDS

  • General Practice Dentistry
  • Huron, SD
National Provider Identifier
1497832414
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
M422 Issued in SD
Practice address
1010 Dakota Ave S
Huron, SD 57350-3318
Phone
(605) 352-6999
Fax
(605) 352-0472
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X M422 SD Primary

Addresses

Primary practice location

1010 Dakota Ave S
Huron, SD 57350-3318

Mailing address

1010 Dakota Ave S
Huron, SD 57350-3318
Phone (605) 352-6999

Other identifiers 1

IdentifierTypeStateIssuer
7801450MedicaidSD

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150715000001 SD Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5092028449

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bruce D Wintle DDS Past Accepting new patients
Dakota Family Dentistry, Prof. LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497832414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 DAKOTA AVE S",
            "city": "HURON",
            "state": "SD",
            "postal_code": "573503318",
            "telephone_number": "605-352-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 DAKOTA AVE S",
            "city": "HURON",
            "state": "SD",
            "postal_code": "573503318",
            "telephone_number": "605-352-6999",
            "fax_number": "605-352-0472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINTLE",
        "first_name": "BRUCE",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "M422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7801450",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huron, SD

Sources for this page

Verify at the official NPI Registry.