NPIMap

James Kenneth Byrne, DDS

Individual provider Active NPI General Practice Dentistry · Rapid City, SD

NPI 1811014111 · NPPES record last updated Mar 12, 2014

Key facts

NPI
1811014111
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
M688 (SD)
Practice address
3825 Canyon Lake Drive
Rapid City, SD 57702
Phone
(605) 342-1200
Fax
(605) 342-2622
NPI assigned
Mar 23, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
M688SDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Byrne Dental, Professional LLC General Practice Current
since Oct 11, 2020		 Accepting new patients

Locations

3825 Canyon Lake Dr
Rapid City, SD 57702
Phone (605) 342-1200

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X M688 SD Yes

Addresses

Primary practice location

3825 Canyon Lake Drive
Rapid City, SD 57702

Mailing address

3825 Canyon Lake Drive
Rapid City, SD 57702
Phone (605) 342-1200

Other providers in Rapid City, SD

All providers in Rapid City, SD · General Practice Dentistry in South Dakota

Sources for this page

Verify at the official NPI Registry.