Brandon S Kvidt, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D13083 Issued in MN

Practice address

2900 Doolittle Dr BLDG 6000
Ellsworth AFB, SD 57706-4821

Phone

(605) 385-3657

NPI assigned

Apr 23, 2012

Last updated

Sep 20, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1750648291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 DOOLITTLE DR BLDG 6000",
            "city": "ELLSWORTH AFB",
            "state": "SD",
            "postal_code": "577064821",
            "telephone_number": "605-385-3657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 DOOLITTLE DR BLDG 6000",
            "city": "ELLSWORTH AFB",
            "state": "SD",
            "postal_code": "577064821",
            "telephone_number": "605-385-3657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KVIDT",
        "first_name": "BRANDON",
        "middle_name": "S",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-23",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13083",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Crystal Kim-Ferger, DDS
• Shannon Brittany Kiperash, PA-C
• Kelvin K Krause, DDS
• Scott Joseph Krebs, PHD
• Amy Marie Kubal
• Joshua J Larson, M.D.
• Gina Ann Laux, IDMT
• Seth Leavitt, DO
• Craig A Lequatte, RPH
• Elizabeth Grace Linder, DDS

• Dentist in Ellsworth AFB, SD
• Providers in Ellsworth AFB, SD by specialty
• Dentist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; 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.