Kaibab PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

KAIBAB PC

Practice address

714 S 2ND St
Bismarck, ND 58504-5718

Phone

(701) 258-3308

Fax

(701) 751-0349

NPI assigned

Mar 25, 2024

Organization subpart

No

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

Authorized official

Name

Brielle Renz, DMDNPI 1316389794

Title

Owner

Phone

(701) 258-3308

Specialties & licenses 2

Addresses

Other names 1

• ALL SMILES DENTAL Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brielle Mary Renz, DMD

  • General Practice Dentistry
  • Bismarck, ND
  • NPI 1316389794
  NPD Authorized official
• Dean David Knudsen, D.D.S

  • Dentist
  • Bismarck, ND
  • NPI 1942420880
  NPD (past)

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711324800000",
    "number": "1578313201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 S 2ND ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045718",
            "telephone_number": "701-258-3308",
            "fax_number": "701-751-0349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 S 2ND ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045718",
            "telephone_number": "701-258-3308",
            "fax_number": "701-751-0349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAIBAB PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A",
        "authorized_official_last_name": "RENZ",
        "authorized_official_first_name": "BRIELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-258-3308",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALL SMILES DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Connie Jo Kadrmas, FNP-BC
• Nicolas David Kadrmas, PHARM.D.
• Kayla Kafka
• Chad Michael Kahl
• Jamie Janelle Kahl, D.C.
• Jessica Kaiser, MS, OTR/L
• Joseph Kaiser, PHARMD
• Kyle Kaiser, RN/NREMT-P
• Matthew Kalonick
• Victoria Kamara

• General Practice Dentistry in Bismarck, ND
• Providers in Bismarck, ND by specialty
• General Practice Dentistry in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.