Allen Ray Bond, DDS
Individual provider Active NPI Dentist · Rapid City, SD
NPI 1912935107 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1912935107
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- M973 (SD)
- Practice address
- 504 E Monroe St
Rapid City, SD 57701-1400 - Phone
- (605) 394-6665
- Fax
- (605) 355-3508
- NPI assigned
- Jun 28, 2006
- Sex
- Male
- 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)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Center of the Black Hills Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | M973 | SD | Yes |
Addresses
Primary practice location
504 E Monroe St
Rapid City, SD 57701-1400
Mailing address
504 E Monroe St
Rapid City, SD 57701-1400
Phone (605) 394-6665
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5350060 | Medicaid | SD |
Other providers in Rapid City, SD
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.