Active NPI
North Sioux Dental Clinic
- General Practice Dentistry
- North Sioux City, SD
National Provider Identifier
1912048687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- M847
- Legal business name
- NORTH SIOUX DENTAL CLINIC
- Practice address
- 101 Merrill Ave.
North Sioux City, SD 57049 - Phone
- (605) 232-8802
- Fax
- (605) 232-0973
- NPI assigned
- Feb 8, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Donald B Cork Jr., DDS
- Title
- General Dentist
- Phone
- (605) 232-8802
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | M847 | SD | Primary |
Addresses
Primary practice location
101 Merrill Ave.
North Sioux City, SD 57049
Mailing address
101 Merrill Ave.
PO Box 1010
North Sioux City, SD 57049
Phone (605) 232-8802
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0722009 | Medicaid | IA | |
| 0989517 | Medicaid | IA |
National Provider Directory
National Provider DirectoryLocations
101 Merrill Ave
North Sioux City, SD 57049
Phone (605) 232-8802
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Melbourne, FL
- NPI 1346322716
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1912048687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 MERRILL AVE.",
"address_2": "PO BOX 1010",
"city": "NORTH SIOUX CITY",
"state": "SD",
"postal_code": "57049",
"telephone_number": "605-232-8802",
"fax_number": "605-232-0973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 MERRILL AVE.",
"city": "NORTH SIOUX CITY",
"state": "SD",
"postal_code": "57049",
"telephone_number": "605-232-8802",
"fax_number": "605-232-0973"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTH SIOUX DENTAL CLINIC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-08",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "CORK",
"authorized_official_first_name": "DONALD",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "GENERAL DENTIST",
"authorized_official_telephone_number": "605-232-8802",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "SD",
"license": "M847",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0722009",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0989517",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Sioux City, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.