Organization Active NPI

McCook County Dentalcenter,PC

  • General Practice Dentistry
  • Salem, SD
National Provider Identifier
1962615344
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
M675 Issued in SD
Legal business name
MCCOOK COUNTY DENTALCENTER,PC
Practice address
440 East Rutan Avenue
Salem, SD 57058-0549
Phone
(605) 425-2725
Fax
(605) 425-9724
NPI assigned
May 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mary Ann Dick, DDS
Title
Owner
Phone
(605) 425-2725

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X M675 SD Primary

Addresses

Primary practice location

440 East Rutan Avenue
Salem, SD 57058-0549

Mailing address

440 East Rutan Avenue
PO Box 549
Salem, SD 57058-0549
Phone (605) 425-2725

Other names 1

  • MAry Ann Dick,DDS Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962615344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 EAST RUTAN AVENUE",
            "address_2": "PO BOX 549",
            "city": "SALEM",
            "state": "SD",
            "postal_code": "570580549",
            "telephone_number": "605-425-2725",
            "fax_number": "605-425-9724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 EAST RUTAN AVENUE",
            "city": "SALEM",
            "state": "SD",
            "postal_code": "570580549",
            "telephone_number": "605-425-2725",
            "fax_number": "605-425-9724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCOOK COUNTY DENTALCENTER,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DICK",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-425-2725",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "M675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAry Ann Dick,DDS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Salem, 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.

Verify at the official NPI Registry.