Premier Endodontics, PC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

PREMIER ENDODONTICS, PC

Doing business as

Summit Endodontics

Practice address

703 Quincy St Ste 2
Rapid City, SD 57701-3674

Phone

(605) 868-6422

NPI assigned

Jan 30, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Steven Frederick Wiswall, DMD, MSNPI 1316389117

Title

President

Phone

(605) 868-6422

Specialties & licenses 1

Addresses

Other names 1

• Summit Endodontics Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven Frederick Wiswall, DMD, MS

  • Endodontics
  • Rapid City, SD
  • NPI 1316389117
  NPD Authorized official

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1902512163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13170 BRIDGE LN",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577028523",
            "telephone_number": "605-868-6422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 QUINCY ST STE 2",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577013674",
            "telephone_number": "605-868-6422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ENDODONTICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "WISWALL",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "605-868-6422",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Endodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Prairie Hills Care and Rehabilitation Center LLC (Prairie Hills Care and Rehabilitation Center)
• Jocelyn F. Prang, RPH, DDSM
• Miranda M Pray-Dede
• Madison Preble
• Precision Eyecare PC
• Premier Eyecare P.C.
• Presbyterian Retirement Village of Rapid City, Inc. (Westhills Village Home Health)
• Presbyterian Retirement Village of Rapid City, Inc. (Clarkson Health Care)
• Presbyterian Retirement Village of Rapid City, Inc. (Westhills Village Healthcare)
• Presbyterian Retirement Village of Rapid City, Inc. (The Courtyard Westhills Village)

• Endodontics in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Endodontics in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.