Jeri L. Scranton-Skyberg, DDS
Individual provider Active NPI General Practice Dentistry · Rapid City, SD
NPI 1609970169 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1609970169
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- M776 (SD)
- Practice address
- 200 Federal Ave
Rapid City, SD 57702-2326 - Phone
- (605) 348-4657
- Fax
- (605) 348-4382
- NPI assigned
- Sep 12, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M776 | SD | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bart a. Samuelson DDS, PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | M776 | SD | Yes |
Addresses
Primary practice location
200 Federal Ave
Rapid City, SD 57702-2326
Mailing address
200 Federal Ave
Rapid City, SD 57702-2326
Phone (605) 348-4657
Other providers in Rapid City, SD
- David Arthur Schwietert
- James Wesley Schwietert
- Aiyana Scott
- Kari Ann Scovel Hendrickson
- Scovel Psychological and Counseling Services, LTD
- SD Specialty Dental Services, LLC
- SD Telehealth, PLLC
- Klaire Sealey
- Mariah Sears
- Nicole Sears
All providers in Rapid City, SD · General Practice Dentistry in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.