Charles F. Scanlon II, D.D.S., MSD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

D0968 Issued in SD

Practice address

5955 South Highway 16
Suite a
Rapid City, SD 57701-8911

Phone

(605) 721-1111

NPI assigned

Sep 17, 2008

Last updated

Apr 17, 2013By 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 2

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

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.

• Charles F Scanlon II DDS MSD PC

  dba West River Periodontics and Implant Dentistry

  • Periodontics
  • Rapid City, SD
  • NPI 1669079257
  NPD

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366156800000",
    "number": "1568611374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 SOUTH HIGHWAY 16",
            "address_2": "SUITE A",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577018911",
            "telephone_number": "605-721-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 SOUTH HIGHWAY 16",
            "address_2": "SUITE A",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577018911",
            "telephone_number": "605-721-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANLON",
        "first_name": "CHARLES",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.D.S., MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-17",
        "last_updated": "2013-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "4492",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "SD",
            "license": "D0968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephannie Saunders
• Morgan Lynne Sauvage, PA-C
• Trey Alexander Sauvage, DDS
• Ingrid Ann Savery
• Kayla Sayer
• Ryan Leo Scarborough, OD
• Schaack Family Dentistry, P.C. (Pine Peaks Dental)
• Jon K Schaack, DDS
• Tara T Schaack, DDS
• Alexander M a Schabauer, MD

• Periodontics in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Periodontics in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; 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.