Active NPI
Damon James Thielen, DMD
- Dentist
- Sioux Falls, SD
National Provider Identifier
1932467875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6864-15
- Practice address
- 3813 S Kiwanis Cir
Sioux Falls, SD 57105-4266 - Phone
- (605) 280-2337
- NPI assigned
- Apr 29, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6864-15 | WI | Primary |
| Pediatric Dentistry | 1223P0221X | D0982 | SD |
Addresses
Primary practice location
3813 S Kiwanis Cir
Sioux Falls, SD 57105-4266
Mailing address
3813 S Kiwanis Cir
Sioux Falls, SD 57105-4266
Phone (605) 280-2337
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6864-15 | WI | MD | Dentist |
| D0982 | SD | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369958400000",
"number": "1932467875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3813 S KIWANIS CIR",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571054266",
"telephone_number": "605-280-2337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3813 S KIWANIS CIR",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571054266",
"telephone_number": "605-280-2337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIELEN",
"first_name": "DAMON",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-29",
"last_updated": "2013-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "6864-15",
"primary": true
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "SD",
"license": "D0982",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sioux Falls, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.