Jade A Desmidt, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2369 Issued in ND

Practice address

121 E Front Ave
Bismarck, ND 58504

Phone

(701) 223-1194

NPI assigned

Jun 7, 2013

Last updated

Sep 25, 2019By the provider in NPPES

Sex

Female

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Missouri Dental Professionals, Richard Straus, DMD, PC

  dba Deer Creek Dental

  • General Practice Dentistry
  • O'Fallon, MO
  • NPI 1952521460
  NPD (past)

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

{
    "created_epoch": "1370563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1982042362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 E FRONT AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045589",
            "telephone_number": "701-223-1194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 E FRONT AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "58504",
            "telephone_number": "701-223-1194"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 E Front Ave",
            "address_purpose": "LOCATION",
            "city": "Bismarck",
            "state": "ND",
            "postal_code": "58504",
            "country_code": "US",
            "telephone_number": "701-223-1194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESMIDT",
        "first_name": "JADE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-07",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "2369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Jeanette Deraney, MD
• Derik Hoerner, DDS, PC (Bismarck Advanced Dental and Implants)
• Derosier Chiropractic Clinic, P.C.
• Matthew Richard Derosier, D.C.
• Nayan K Desai, MD
• Eusebio Chiong Desuyo, M.D.
• Mark Detwiller, M.D.
• Ricky L Detwiller, R.PH.
• Dina Devaraj, MD
• Devine Home Care LLC

• General Practice Dentistry in Bismarck, ND
• Providers in Bismarck, ND by specialty
• General Practice Dentistry in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; 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.