Dakota Regional Periodontics, LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

DAKOTA REGIONAL PERIODONTICS, LLC

Practice address

2800 Jackson Blvd Ste 6
Rapid City, SD 57702-3477

Phone

(605) 348-2556

Fax

(605) 348-1526

NPI assigned

Aug 24, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Mark Allen Terry, DDS

Title

Partner/Owner

Phone

(605) 348-2556

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535068800000",
    "number": "1962983205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 JACKSON BLVD STE 6",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577023477",
            "telephone_number": "605-348-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 JACKSON BLVD STE 6",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577023477",
            "telephone_number": "605-348-2556",
            "fax_number": "605-348-1526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAKOTA REGIONAL PERIODONTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-24",
        "last_updated": "2018-08-24",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PARTNER/OWNER",
        "authorized_official_telephone_number": "605-348-2556",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Periodontics in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; 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.