Individual provider Active NPI

Nathan William Schwandt, D.D.S.

  • Endodontics
  • Rapid City, SD
National Provider Identifier
1609966779
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
M955 Issued in SD
Practice address
2525 W Main St
Suite 206
Rapid City, SD 57702-0901
Phone
(605) 348-4868
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X M955 SD Primary

Addresses

Primary practice location

2525 W Main St
Suite 206
Rapid City, SD 57702-0901

Mailing address

2525 W Main St
Suite 206
Rapid City, SD 57702-0901
Phone (605) 348-4868

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20141016000224 SD Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0941421945

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
M955SDMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609966779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 W MAIN ST",
            "address_2": "SUITE 206",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577020901",
            "telephone_number": "605-348-4868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 W MAIN ST",
            "address_2": "SUITE 206",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577020901",
            "telephone_number": "605-348-4868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWANDT",
        "first_name": "NATHAN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "SD",
            "license": "M955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.