Individual provider Active NPI

Nicole Marie Duckwitz, DDS

  • Dentist
  • Mandan, ND
National Provider Identifier
1497981435
Registry record updated Jun 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2050 Issued in ND
Practice address
204 3Rd Ave NW
Mandan, ND 58554-3130
Phone
(701) 663-7545
Fax
(701) 663-6174
NPI assigned
Jun 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2050 ND Primary

Addresses

Primary practice location

204 3Rd Ave NW
Mandan, ND 58554-3130

Mailing address

204 3Rd Ave NW
Mandan, ND 58554-3130
Phone (701) 663-7545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2050NDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Associates Inc Dentist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244073600000",
    "number": "1497981435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 3RD AVE NW",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585543130",
            "telephone_number": "701-663-7545",
            "fax_number": "701-663-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 3RD AVE NW",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585543130",
            "telephone_number": "701-663-7545",
            "fax_number": "701-663-6174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKWITZ",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-04",
        "last_updated": "2009-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ND",
            "license": "2050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandan, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2009; 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.