Erik Mark Treman Wiseman, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D0624 Issued in SD

Practice address

719 Main Ave
Brookings, SD 57006-1426

Phone

(605) 692-9555

Fax

(605) 692-0967

NPI assigned

May 10, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

• Wiseman & Tidstrom Dental Management, LLC

  dba Prairie Skies Family Dentristry

  • Dentist
  • Brookings, SD
  • NPI 1427428614
  Authorized official Same address or phone

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871707554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 MAIN AVE",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570061426",
            "telephone_number": "605-692-9555",
            "fax_number": "605-692-0967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 MAIN AVE",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570061426",
            "telephone_number": "605-692-9555",
            "fax_number": "605-692-0967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "ERIK",
        "middle_name": "MARK TREMAN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "D0624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willert Enterprises PC (Willert Wellness & Chiropractic)
• Dennis Jay Willert, DC
• Jennifer Elaine Williamson, M.D.
• Brooke Madison Wilmesherr, CCC-SLP
• Wiseman & Tidstrom Dental Management, LLC (Prairie Skies Family Dentristry)
• Bradley D. Woldt, PH.D.
• Blake Wooten
• Wyatt Nash-Keller OD Prof LLC
• Christina Yackley, DC
• Yorkshire Eye Clinic,LTD

• General Practice Dentistry in Brookings, SD
• Providers in Brookings, SD by specialty
• General Practice Dentistry in South Dakota

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.