Kimberly Jean Bork, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D1033 Issued in SD

Practice address

304 W. Highway 38
Suite 138
Hartford, SD 57033

Phone

(605) 528-6750

Fax

(605) 528-6752

NPI assigned

Jul 5, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Kimberly Jean Yingst Former name

Electronic endpoints 1

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 and National Provider Directory roles.

• Mattheis Hartford Dental Clinic, P.C.

  • Dentist
  • Hartford, SD
  • NPI 1962830455
  NPD (past)

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

{
    "created_epoch": "1372982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1609216670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 757",
            "city": "HARTFORD",
            "state": "SD",
            "postal_code": "570330757",
            "telephone_number": "605-528-6750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 W. HIGHWAY 38",
            "address_2": "SUITE 138",
            "city": "HARTFORD",
            "state": "SD",
            "postal_code": "57033",
            "telephone_number": "605-528-6750",
            "fax_number": "605-528-6752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORK",
        "first_name": "KIMBERLY",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-05",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "D1033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hartdentcln@goldenwest.net",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "304 W. Highway 38",
            "address_2": "Suite 138",
            "city": "Hartford",
            "state": "SD",
            "country_code": "US",
            "postal_code": "57033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "YINGST",
            "middle_name": "JEAN",
            "prefix": "DR.",
            "credential": "D.M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Hartford, SD
• General Practice Dentistry in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.