GERARD F KOORBUSCH (NPI# 1003859224) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003859224 |
| Entity Type | Individual |
| Full Name | GERARD F KOORBUSCH |
| Credential | DDS, MBA |
| Practice Address |
1140 W Capitol Ave Bismarck ND 58501-9956 |
| Practice Telephone | 7012587220 |
| Practice Fax Number | 7012222329 |
| Mailing Telephone | 7012587220 |
| Mailing Fax Number | 7012222329 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2010-12-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
1818 | ND | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | DENTAL LICENSE | 1818 | 01 |
| ND | 41121 | 05 |
| Street Address |
1140 W CAPITOL AVE |
| City | BISMARCK |
| State | ND |
| Zip Code | 58501-9956 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184667305 | Face and Jaw Surgeons PC | Dentist | 1140 W Capitol Ave, Bismarck, ND 58501-9956 | 2006-06-14 |
| 1508483900 | Peake Ot Myofascial Release | Occupational Therapist | 1140 W Capitol Ave, Bismarck, ND 58501-1306 | 2020-07-01 |
| 1316597065 | Empower Physical Therapy LLC | Physical Therapist | 1140 W Capitol Ave, Bismarck, ND 58501-1306 | 2019-09-15 |
| 1265836977 | Embrace Wellness Pllc | Clinic/Center | 1140 W Capitol Ave, Bismarck, ND 58501-1306 | 2014-10-09 |
| 1811173834 | Michelle M Peake | Occupational Therapist | 1140 W Capitol Ave, Bismarck, ND 58501 | 2008-01-21 |
| 1831243005 | Michelle D Maier | Nurse Practitioner | 1140 W Capitol Ave, Bismarck, ND 58501-1306 | 2007-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811500911 | Sonja Lee Bosch | Counselor | 101 E. Broadway Ave Heartview Foundation, Bismarck, ND 58501 | 2020-08-28 |
| 1649740630 | Stephanie Marie Simburger | Social Worker | 3111 East Broadway Ave, Bismarck, ND 58501 | 2018-12-03 |
| 1679042519 | Prairie Rose Family Dentists | Dentist | 1110 College Dr., Suite 110, Bismark, ND 58501 | 2018-11-21 |
| 1386111276 | Arielle Joy Flynn | Genetic Counselor, MS | 414 N Seventh Street, Bismarck, ND 58501 | 2018-10-29 |
| 1164901799 | Karalee Joy Harper | Counselor | 101 E. Broadway Ave, Bismarck, ND 58501 | 2018-08-14 |
| 1518457811 | Myckenzie Saari | Behavior Technician | 1929 N Washington St., Bismarck, ND 58501 | 2018-05-14 |
| 1831687532 | Jacquelyn Mahoney | Behavioral Analyst | 604 North Ave, Bismarck, ND 58501 | 2018-04-27 |
| 1710403811 | Kayla Marie Watson | Behavior Technician | 1500 E. Capitol Ave, Suite 200, Bismarck, ND 58501 | 2017-08-21 |
| 1306368220 | Scott Vandyke | Occupational Therapist | 300 N. 7th St, Bismarck, ND 58501 | 2017-07-12 |
| 1144670019 | Bismarck Psychological Associates, Pllc | Psychologist | 107 W. Main Ave., Suite 225, Bismarck, ND 58501 | 2016-06-21 |
| Find all providers in zip 58501 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477723591 | Oral Surgery Center of Bismarck, PC | Dentist | 3117 N 14th St, Bismarck, ND 58503-0664 | 2008-03-04 |
| 1588697015 | Phillip T. Iero, M.d.,d.d.s., PC | Dentist | 416 N 6th St, Bismarck, ND 58501-4416 | 2006-07-08 |
| 1285670067 | John G Stanley | Dentist | 2331 Tyler Pkwy, Suite 4, Bismarck, ND 58503-0871 | 2006-06-21 |
| 1184667305 | Face and Jaw Surgeons PC | Dentist | 1140 W Capitol Ave, Bismarck, ND 58501-9956 | 2006-06-14 |
| 1003859117 | Joseph Richard Deatherage | Dentist | 1730 Burnt Boat Dr Ste 300, Bismarck, ND 58503-0886 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396343737 | Face and Jaw Surgeons PC | Dentist | 1517 12 Ave Ne, Jamestown, ND 58401 | 2020-10-16 |
| 1649816828 | Dr. Jeremiah J. Glosenger, PC | Dentist | 2615 Elk Dr Ste 3, Minot, ND 58701-1200 | 2019-11-21 |
| 1255759650 | Implant&maxillofacial Surgical Center | Dentist | 2224 1st Ave W Ste 2, Williston, ND 58801-6286 | 2014-04-02 |
| 1457420564 | Face and Jaw Surgeons PC | Dentist | 2845 36 Ave South, Grand Forks, ND 58201-6747 | 2006-11-06 |
| 1073697157 | Troy R Petersen | Dentist | 1165c South Columbia Road, Grand Forks, ND 58201-4007 | 2006-10-25 |
| 1790889152 | Rudy J Schneider | Dentist | 3187 Blue Stem Dr Ste 4, West Fargo, ND 58078-8008 | 2006-09-07 |
| 1245272277 | Trinity Health | Dentist | 2815 16th St Sw Ste 100, Minot, ND 58701-6916 | 2006-06-12 |
| 1538147848 | Michael J Noffze | Dentist | 2856 Brandt Dr S, Fargo, ND 58104-8805 | 2006-01-06 |
| 1770584500 | John Tennis Keaveny | Dentist | 669 12th St W, Suite 2, Dickinson, ND 58601-3554 | 2005-08-02 |
| 1295739233 | Edward Francis May | Dentist | 2585 23rd Ave S, Ste A., Fargo, ND 58103 | 2005-06-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.