NPIMap

Organization Active NPI

Gregg Van Beek DDS PC

Doing business as Northeastern Dental Center

  • General Practice Dentistry
  • Aberdeen, SD
National Provider Identifier
1932403938
Registry record updated Jan 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
M664 Issued in SD
Legal business name
GREGG VAN BEEK DDS PC
Doing business as
Northeastern Dental Center
Practice address
3015 6TH Ave SE
Suite #12
Aberdeen, SD 57401-5461
Phone
(605) 226-3939
Fax
(605) 226-3428
NPI assigned
Jan 5, 2011
Last updated
Jan 5, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2011

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

Authorized official

Name
Dr. Gregg Van Beek, DDSNPI 1790861763
Title
Owner
Phone
(605) 226-3939

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)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X M664 SD Primary

Addresses

Primary practice location

3015 6TH Ave SE
Suite #12
Aberdeen, SD 57401-5461

Mailing address

3015 6TH Ave SE
Suite #12
Aberdeen, SD 57401-5461
Phone (605) 226-3939

Other identifiers 1

IdentifierTypeStateIssuer
7805395MedicaidSD

Other names 1

  • Northeastern Dental Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gregg Van Beek DDS PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3015 6th Ave SE
Ste 12
Aberdeen, SD 57401
Phone (605) 226-3939

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1294185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294185600000",
    "number": "1932403938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 6TH AVE SE",
            "address_2": "SUITE #12",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574015461",
            "telephone_number": "605-226-3939",
            "fax_number": "605-226-3428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 6TH AVE SE",
            "address_2": "SUITE #12",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574015461",
            "telephone_number": "605-226-3939",
            "fax_number": "605-226-3428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGG VAN BEEK DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-05",
        "last_updated": "2011-01-05",
        "status": "A",
        "authorized_official_last_name": "VAN BEEK",
        "authorized_official_first_name": "GREGG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-226-3939",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "M664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805395",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeastern Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aberdeen, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; 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.