WISEMAN & TIDSTROM DENTAL MANAGEMENT, LLC (NPI# 1427428614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427428614 |
| Entity Type | Organization |
| Organization Name | WISEMAN & TIDSTROM DENTAL MANAGEMENT, LLC |
| Other Organization Name | PRAIRIE SKIES FAMILY DENTRISTRY |
| Practice Address |
420 Front Street Brookings SD 57006 |
| Practice Telephone | 6056929555 |
| Practice Fax Number | 6056920967 |
| Mailing Telephone | 6056929555 |
| Mailing Fax Number | 6056920967 |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2017-03-02 |
| Authorized Official Name | ERIK WISEMAN (DENTIST / OWNER) |
| Authorized Official Telephone | 6056929555 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | Y |
| Parent Organization Name | WISEMAN & TIDSTROM DENTAL MANAGEMENT, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | D0624 | SD | Dental Providers |
| Y | 122300000X | Dentist | Dental Providers |
| Other Name | Type Code |
|---|---|
| Prairie Skies Family Dentristry | Doing Business As Name - Organization |
| Street Address |
420 FRONT STREET |
| City | BROOKINGS |
| State | SD |
| Zip Code | 57006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720685845 | Leah Kroeger | Specialist/Technologist | 2820 Stanley J Marshall Center, Brookings, SD 57006 | 2020-10-01 |
| 1619454774 | Alec Edward Weis | Student in an Organized Health Care Education/Training Program | 314 Main Ave Apt 4., Brookings, SD 57006 | 2018-07-22 |
| 1629569066 | Robin Lynn Erz | Counselor | East Central Behavioral Health, 211 4th Street, Brookings, SD 57006 | 2018-05-22 |
| 1982057246 | City of Brookings | Clinic/Center | 310 22nd Avenue, Brookings, SD 57006 | 2016-07-21 |
| 1922413806 | Avera Mckennan | Clinic/Center | 400 2nd Ave, Brookings, SD 57006 | 2014-06-30 |
| 1093157554 | Nathan William Hilbrands | Dentist | 427 8th St S, Brookings, SD 57006 | 2013-07-25 |
| 1992073951 | Andrea Uckert | Counselor | 619 5th Ave Ste 3, Brookings, SD 57006 | 2011-12-06 |
| 1972800100 | Melissa Ann Klemm | Counselor | 1304 Main Ave S, Brookings, SD 57006 | 2011-02-24 |
| 1285873539 | Amy Lynn Osterberg | Counselor | 211 4th St., East Central Mh/cd Center Inc, Brookings, SD 57006 | 2009-02-10 |
| 1114062072 | Kendalls Rexall Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 223 6th St, Brookings, SD 57006 | 2007-02-20 |
| Find all providers in zip 57006 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356835946 | Abigail Joy Vanliere | Dentist | 2110 12th St S, Brookings, SD 57006-5609 | 2018-06-18 |
| 1538510482 | Prouty Brookings Dental, LLC | Dentist | 2220 Yorkshire Dr, Brookings, SD 57006-2442 | 2016-06-22 |
| 1003236134 | Eugene Chickinell | Dentist | 548 Pacific Ave, Brookings, OR 97415-8982 | 2014-04-16 |
| 1093157554 | Nathan William Hilbrands | Dentist | 427 8th St S, Brookings, SD 57006 | 2013-07-25 |
| 1841553708 | Bradley David Jordan | Dentist | 102 22nd Ave S, Brookings, SD 57006-2654 | 2012-06-15 |
| 1265507578 | Charles Stephen Hurst | Dentist | 628 Fleet Street, Brookings, OR 97415 | 2006-11-21 |
| 1275619280 | Kevin Eugene Hardesty | Dentist | 307 Fern Ave., Brookings, OR 97415 | 2006-10-31 |
| 1588751127 | Gene Chickinell Dds PC | Dentist | 548 Pacific Avenue, Brookings, OR 97415 | 2006-10-06 |
| 1528173085 | Daniel William Carlson | Dentist | 102 22nd Ave So, Brookings, SD 57006 | 2006-08-21 |
| 1700316999 | Brian Lee Naylor | Dentist | 97829 Shopping Center Ave, Brookings, OR 97415-9135 | 2017-06-19 |
| Find all providers in BROOKINGS | ||||
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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.