Brian T Wiswall DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

M446 Issued in SD

Legal business name

BRIAN T WISWALL DDS PC

Practice address

518 N Sycamore Avenue
Sioux Falls, SD 57110-5737

Phone

(605) 373-0245

Fax

(605) 336-3261

NPI assigned

Oct 6, 2006

Organization subpart

No

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

Authorized official

Name

Brian T Wiswall, DDS

Title

President

Phone

(605) 373-0245

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497842801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 N SYCAMORE AVENUE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571105737",
            "telephone_number": "605-373-0245",
            "fax_number": "605-336-3261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 N SYCAMORE AVENUE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571105737",
            "telephone_number": "605-373-0245",
            "fax_number": "605-336-3261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN T WISWALL DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WISWALL",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "605-373-0245",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "M446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Sioux Falls, SD
• General Practice Dentistry in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.