Individual provider Active NPI

Kamila Leeannn Dornfeld, D.D.S.

  • Dentist
  • Williston, ND
National Provider Identifier
1962799114
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2081 Issued in ND
Practice address
2224 1St Ave W Ste 1
Williston, ND 58801-6286
Phone
(701) 577-7611
Fax
(701) 577-0139
NPI assigned
Jul 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2081 ND
Dentist 122300000X 2081 ND Primary

Addresses

Primary practice location

2224 1St Ave W Ste 1
Williston, ND 58801-6286

Mailing address

2224 1St Ave W Ste 1
Williston, ND 58801-6286
Phone (701) 577-7611

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

LicenseStateTypeSpecialty
2081NDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sincere Smiles PC Dentist CurrentSince Mar 11, 2025 Accepting new patients

Locations

2224 1st Ave W
Williston, ND 58801
Phone (701) 774-0259

2224 1st Ave W
Ste 1
Williston, ND 58801
Phone (701) 577-7611

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1962799114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2224 1ST AVE W STE 1",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588016286",
            "telephone_number": "701-577-7611",
            "fax_number": "701-577-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2224 1ST AVE W STE 1",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588016286",
            "telephone_number": "701-577-7611",
            "fax_number": "701-577-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORNFELD",
        "first_name": "KAMILA",
        "middle_name": "LEEANNN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-07",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "2081",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ND",
            "license": "2081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; 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.