Brock T Nelsen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D1158 Issued in SD

Practice address

5121 S Solberg Ave #120
Sioux Falls, SD 57108

Phone

(605) 339-2955

NPI assigned

Jun 14, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 9, 2021 through Nov 9, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Great Plains Dental

  • General Practice Dentistry
  • Sioux Falls, SD
  • NPI 1477748275
  NPD (past)

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497398400000",
    "number": "1952831786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46219 PELICAN CV",
            "city": "WENTWORTH",
            "state": "SD",
            "postal_code": "570757518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 S SOLBERG AVE #120",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "57108",
            "telephone_number": "605-339-2955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSEN",
        "first_name": "BROCK",
        "middle_name": "T",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-14",
        "last_updated": "2017-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "D1158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alisha Neises, CNP
• Bailey James Neises, PT
• Eydie Neises, RN
• Chad R Nekl
• Robert A Nelimark, M.D.
• Nelson Therapy LLC
• Amy L. Nelson, MD
• Andrea Neil Nelson, CRNA
• Ann Marie Coddington Nelson, CTRS
• Benjamin Dolan Nelson

• General Practice Dentistry in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• General Practice Dentistry in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.