CARL MCCAMEY KIMBLER (NPI# 1104984483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104984483 |
| Entity Type | Individual |
| Full Name | CARL MCCAMEY KIMBLER |
| Credential | DMD MD |
| Practice Address |
820 1st Ave Se Suite 400 Aberdeen SD 57401-4601 |
| Practice Telephone | 6052259362 |
| Practice Fax Number | 6052297317 |
| Mailing Telephone | 6052259362 |
| Mailing Fax Number | 6052297317 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2013-03-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
SD4237 | SD | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
M862 | SD | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | BLUE CROSS | 0006084 | 01 |
| ND | 41240 | 05 | |
| SD | 8000400 | 05 |
| Street Address |
820 1ST AVE SE SUITE 400 |
| City | ABERDEEN |
| State | SD |
| Zip Code | 57401-4601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376831933 | Avera St. Luke's | Otolaryngology | 820 1st Ave Se, Suite 100, Aberdeen, SD 57401 | 2011-07-18 |
| 1487718565 | Northern Plains Oral and Maxillofacial Surgery LLC | Dentist | 820 1st Ave Se, Suite 400, Aberdeen, SD 57401-4601 | 2006-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679002950 | Brenda Lee Pence | Registered Nurse | 305 S. State St., Aberdeen, SD 57401 | 2017-06-08 |
| 1104366475 | Jordan Shangreaux | Specialist/Technologist | 2200 S Roosevelt St, Aberdeen, SD 57401 | 2017-03-06 |
| 1205387545 | Midwest Medical Transport Company, LLC-aberdeen, Sd | Ambulance | 2919 Industrial Avenue, Aberdeen, SD 57401 | 2016-10-21 |
| 1356752471 | Cameron Eichler Enterprises | Hearing Aid Equipment | 110 6th Ave Se Ste 106, Aberdeen, SD 57401 | 2014-05-12 |
| 1184059412 | Richard Allen Ward IIi | Hearing Instrument Specialist | 1315 6th Avenue Se, Suite 4, Aberdeen, SD 57401 | 2013-09-05 |
| 1427395540 | Matthew William Svensen | Physical Therapist | 1109 S Jay St, Aberdeen, SD 57401 | 2013-01-09 |
| 1750655940 | Robert Ashly Froke | Audiologist | 121 4th Ave Sw-suite 1, Natural Hearing Center, Aberdeen, SD 57401 | 2012-03-06 |
| 1457504862 | Rodney S Johnson | Counselor | 14 S Main St Ste 1e, Aberdeen, SD 57401 | 2008-10-29 |
| 1518115005 | Dakota Chiropractic of Aberdeen, PC | Chiropractor | 520 Moccasin Drive, Aberdeen, SD 57401 | 2008-09-09 |
| 1558554626 | Tiffany Zimmerman Hoeft | Speech-Language Pathologist | 39515 Pintail Ave, Aberdeen, SD 57401 | 2007-08-22 |
| Find all providers in zip 57401 | ||||
| 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 |
|---|---|---|---|---|
| 1023413077 | Ehrmantrout & Obenchain, Pllc | Dentist | 800 E Wishkah St, Aberdeen, WA 98520-2915 | 2014-10-31 |
| 1962527531 | David J Parks | Dentist | 321 W 1st St, Aberdeen, WA 98520-6110 | 2007-03-20 |
| 1578947545 | Northwest Imaging LLC | Dentist | 1020 Anderson Dr, Suite 205, Aberdeen, WA 98520-1055 | 2015-07-19 |
| 1568841799 | Obenchain Pllc | Dentist | 1020 Anderson Dr, Ste 205, Aberdeen, WA 98520-1055 | 2015-05-20 |
| 1811193436 | Dr. Kuhn & Associates | Dentist | 1902 N Sandhills Blvd, Suite H, Aberdeen, NC 28315-2382 | 2007-06-21 |
| 1659408284 | David C Obenchain | Dentist | 1020 Anderson Dr, Suite 205, Aberdeen, WA 98520-1055 | 2007-02-28 |
| 1487718565 | Northern Plains Oral and Maxillofacial Surgery LLC | Dentist | 820 1st Ave Se, Suite 400, Aberdeen, SD 57401-4601 | 2006-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821118480 | Brent Jason Henriksen | Dentist | 1700 S. Southeastern Ave., River Ridge Oral and Maxillofacial Surgical Center, Sioux Falls, SD 57103 | 2007-03-29 |
| 1720116866 | Kenneth Vanasma | Dentist | 15308 Grand View Dr, Piedmont, SD 57769-7326 | 2007-03-01 |
| 1720126220 | Gregory P Williams | Dentist | 330 E Stumer Rd, Rapid City, SD 57701-6406 | 2007-02-05 |
| 1649241407 | Harvey A Akerson | Dentist | 6401 S Minnesota Ave, Sioux Falls, SD 57108-2504 | 2006-01-30 |
| 1952381899 | Nathan Alexander Phillips | Dentist | 301 Oak Tree Ln, Dakota Dunes, SD 57049 | 2006-01-18 |
| 1376522714 | River Ridge Oral & Maxillofacial Surgical Center | Dentist | 1700 S Southeastern Ave, Sioux Falls, SD 57103-3227 | 2006-01-13 |
| 1487639316 | Bruce Evan Partnoy | Dentist | 5200 S Cliff Ave, Suite 102, Sioux Falls, SD 57108 | 2005-12-14 |
| 1588083711 | Trevor Holleman | Dentist | 1700 S Southeastern Ave, Sioux Falls, SD 57103 | 2014-04-15 |
| 1518219633 | Community Health Center of The Black Hills, Inc | Dentist | 350 Pine Street, Rapid City, SD 57701 | 2012-10-12 |
| 1710270590 | Jared Eric Dye | Dentist | 301 Oak Tree Ln, Dakota Dunes, SD 57049 | 2011-05-26 |
| 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.