NPIMap

Organization Active NPI

Siouxland Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Sioux Falls, SD
National Provider Identifier
1790757011
Registry record updated Apr 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
SIOUXLAND ORAL SURGERY
Practice address
6401 S Minnesota Ave
Sioux Falls, SD 57108-2504
Phone
(605) 335-1080
Fax
(605) 332-4550
NPI assigned
Feb 2, 2006
Last updated
Apr 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2015

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

Authorized official

Name
Mrs. Peggy Kristin Roth
Title
Insurance Administrator
Phone
(605) 335-1080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU Primary

Addresses

Primary practice location

6401 S Minnesota Ave
Sioux Falls, SD 57108-2504

Mailing address

6401 S Minnesota Ave
Sioux Falls, SD 57108-2504
Phone (605) 335-1080

National Provider Directory

National Provider Directory

Locations

1736 6th St
Brookings, SD 57006
Phone (605) 696-1080

2200 N Kimball St
Ste 1050
Mitchell, SD 57301
Phone (605) 996-0515

6401 S Minnesota Ave
Sioux Falls, SD 57108
Phone (605) 335-1080

409 Summit St
Ste 2700
Yankton, SD 57078
Phone (605) 260-9585

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428969600000",
    "number": "1790757011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 S MINNESOTA AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082504",
            "telephone_number": "605-335-1080",
            "fax_number": "605-332-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 S MINNESOTA AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082504",
            "telephone_number": "605-335-1080",
            "fax_number": "605-332-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIOUXLAND ORAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-02",
        "last_updated": "2015-04-14",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_middle_name": "KRISTIN",
        "authorized_official_title_or_position": "INSURANCE ADMINISTRATOR",
        "authorized_official_telephone_number": "605-335-1080",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; 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.