Brian G Criss, DDS
Individual provider Active NPI General Practice Dentistry · Rapid City, SD
NPI 1881601441 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1881601441
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- M851 (SD)
- Practice address
- 720 Sheridan Lake Rd
Rapid City, SD 57702 - Phone
- (605) 342-6652
- Fax
- (605) 342-6656
- NPI assigned
- Aug 3, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240129001571 | SD | Practitioner - Dentist | 5092128629 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Black Hills Sleep & TMJ Solutions | General Practice | Current |
Accepting new patients |
| Brian G. Criss | General Practice | Past | Accepting new patients |
Locations
2001 Hope Ct
Ste 4
Rapid City, SD 57701
Phone (605) 718-0155
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | M851 | SD | Yes |
Addresses
Primary practice location
720 Sheridan Lake Rd
Rapid City, SD 57702
Mailing address
720 Sheridan Lake Rd
Rapid City, SD 57702
Phone (605) 342-6652
Other providers in Rapid City, SD
- Cindy Creager
- Creekside Medical Clinic, Prof. LLC
- Crisman Dixon & Associates P C
- Crisman Dixon & Associates, P.C.
- Bruce A. Crisman
- Mikayla Crocker
- Kyleigh Anne Cromwell
- Melinda Cronin
- Krista Elizabeth Crook
- Samantha Kay Crooks
All providers in Rapid City, SD · General Practice Dentistry 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 Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.