Elizabeth Joan Munch, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

6608 Issued in NE

Practice address

3220 Plaza Dr.
Suite B
South Sioux City, NE 68776

Phone

(402) 494-2144

Fax

(402) 494-3002

NPI assigned

Oct 30, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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 identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1162166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689750937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 PRAIRIE BLVD",
            "city": "NORTH SIOUX CITY",
            "state": "SD",
            "postal_code": "57049",
            "telephone_number": "402-670-3968",
            "fax_number": "402-494-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 PLAZA DR.",
            "address_2": "SUITE B",
            "city": "SOUTH SIOUX CITY",
            "state": "NE",
            "postal_code": "68776",
            "telephone_number": "402-494-2144",
            "fax_number": "402-494-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNCH",
        "first_name": "ELIZABETH",
        "middle_name": "JOAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "6608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070128",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "05844",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025384100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in South Sioux City, NE
• Providers in South Sioux City, NE by specialty
• Dentist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.