Black Hills Modern Endodontics

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BLACK HILLS MODERN ENDODONTICS

Practice address

655 Omaha St Ste 400
Rapid City, SD 57701-2744

Phone

(605) 791-5900

NPI assigned

Dec 4, 2019

Last updated

Dec 4, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Eric P Wilbur, MDM

Title

Owner

Phone

(605) 791-5900

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1575417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575417600000",
    "number": "1508403957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 OMAHA ST STE 400",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577012744",
            "telephone_number": "605-791-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 OMAHA ST STE 400",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577012744",
            "telephone_number": "605-791-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK HILLS MODERN ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-04",
        "last_updated": "2019-12-04",
        "status": "A",
        "authorized_official_last_name": "WILBUR",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-791-5900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MDM"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Black Hills Hospitalist
• Black Hills Integrative Counseling and Coaching, LLC
• Black Hills Integrative Medicine
• Black Hills Medical Group LLP
• Black Hills Mobile Healthcare LLC
• Black Hills Neuropsychology and Behavioral Health, LLC
• Black Hills Neuropsychology LLC
• Black Hills Obstetrics & Gynecology LLC
• Black Hills Obstetrics and Gynecology LLP
• Black Hills Optometry LLC (The Eyeglass Studio)

• Dental Clinic/Center in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Dental Clinic/Center in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; 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.