CHEYENNE RIVER DENTAL CLINIC (NPI# 1851422596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851422596 |
| Entity Type | Organization |
| Organization Name | CHEYENNE RIVER DENTAL CLINIC |
| Practice Address |
317 North Main St Eagle Butte SD 57625-0590 |
| Mailing Address |
Po Box 590 Eagle Butte SD 57625-0590 |
| Practice Telephone | 6059647830 |
| Practice Fax Number | 6059647800 |
| Mailing Telephone | 6059647830 |
| Mailing Fax Number | 6059647800 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2007-07-18 |
| NPI Deactivation Date | 07/17/2007 |
| NPI Reactivation Date | 2007-07-18 |
| Authorized Official Name | MRS. EVVI L DUPRIS (CRST DENTAL ADMINISTRATIVE MANAGER) |
| Authorized Official Telephone | 6059647830 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223D0001X |
Dentist Specialization: Dental Public Health |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | 5540240 | 05 |
| Street Address |
317 NORTH MAIN ST |
| City | EAGLE BUTTE |
| State | SD |
| Zip Code | 57625-0590 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720230709 | Indian Health Services | General Acute Care Hospital | 317 North Main St, Eagle Butte, SD 57625-1012 | 2008-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659998359 | Jill M Marshall | Registered Nurse | 24279 166th St. Airport Road, Eagle Butte, SD 57625 | 2020-06-29 |
| 1871110890 | Stephen Andrew Williams | Registered Nurse | 24767 166th St, Eagle Butte, SD 57625 | 2020-06-26 |
| 1730706706 | Shannon Renee Brautigan | Registered Nurse | 24276 166th Street Airport Rd., Eagle Butte, SD 57625 | 2020-06-25 |
| 1598327827 | Lucy Manu | Pharmacist | 24276 166th Street; Airport Road, Eagle Butte, SD 57625 | 2019-07-08 |
| 1518429539 | Lisa Marie Brower | Registered Nurse | 24276 166th Street, Airport Rd., Eagle Butte, SD 57625 | 2019-04-01 |
| 1063976025 | Jeff Dixon | Pharmacist | Cheyenne River Health Center 24276 Airport Rd., 166th S, Eagle Butte, SD 57625 | 2019-01-24 |
| 1619455540 | Alycia Oster | Registered Nurse | 24276 166th St Airport Rd, Eagle Butte, SD 57625 | 2018-08-02 |
| 1447765987 | Deidra Monique Hall | Nurse's Aide | 211 S Spiel Court, Eagle Butte, SD 57625 | 2017-12-06 |
| 1295271070 | Cree Iron Cloud | Registered Nurse | #24276 Airport Rd, Eagle Butte, SD 57625 | 2017-01-17 |
| 1922452531 | Holly Mattern | Registered Nurse | 24276 166th Street Airport Rd, Eagle Bute, SD 57625 | 2016-04-20 |
| Find all providers in zip 57625 | ||||
| Taxonomy Code | 1223D0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Dental Public Health |
| The science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice that serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962828285 | Pediatric Dentistry PC | Dentist | 711 Sioux Point Rd. Ste. 100, Dakota Dunes, SD 57049-5099 | 2014-03-11 |
| 1225005473 | Brent L Barker | Dentist | 210 1st., Wanblee, SD 57577 | 2006-03-07 |
| 1467427625 | John Thomas Zimmer | Dentist | 100 Lake Traverse Drive, Sisseton, SD 57262 | 2006-02-21 |
| 1932659539 | Joan Umiker | Dentist | 1323 Bia Route 4, Fort Thompson, SD 57339 | 2016-10-06 |
| 1124363957 | Delta Dental Philanthropic Fund | Dentist | 804 N Euclid Ave, Pierre, SD 57501-1719 | 2012-12-05 |
| 1841372471 | Edward D Gonzales | Dentist | 100 Lake Traverse Dr, Sisseton, SD 57262-0189 | 2006-10-20 |
| City | EAGLE BUTTE |
| Zip Code | 57625 |
Please comment or provide details below to improve the information on CHEYENNE RIVER DENTAL CLINIC.
| 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.