Lara Onischuk, DDS
Individual provider Active NPI Dentist · Belle Fourche, SD
NPI 1861245409 · NPPES record last updated Apr 11, 2024
Key facts
- NPI
- 1861245409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- D1427 (SD)
- Practice address
- 503 Jackson St
Belle Fourche, SD 57717-1716 - Phone
- (605) 892-6347
- NPI assigned
- Apr 11, 2024
- 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 |
|---|---|---|---|
| D1427 | SD | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson Dental Prof. LLC | Dentist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D1427 | SD | |
| Dentist | 122300000X | D1427 | SD | Yes |
Addresses
Primary practice location
503 Jackson St
Belle Fourche, SD 57717-1716
Mailing address
503 Jackson St
Belle Fourche, SD 57717-1716
Phone (605) 892-6347
Other providers in Belle Fourche, SD
- Heidi J Nash
- Nehl Dental, Inc.
- Matt E Nehl
- Mike E. Nehl
- Chelsie Ogaard
- Pain & Movement Solutions, LLC
- Alicia Marie Pritchard
- Christopher Philip Pritchard
- Sara Raue
- Regional Health Network Inc
All providers in Belle Fourche, SD · Dentist 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 Apr 11, 2024. 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.