Healthcare Provider Details

I. General information

NPI: 1831576875
Provider Name (Legal Business Name): JOSHUA W NEHRING DDS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2015
Last Update Date: 04/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 JACKSON BLVD STE 6
RAPID CITY SD
57702-3477
US

IV. Provider business mailing address

2800 JACKSON BLVD STE 6
RAPID CITY SD
57702-3477
US

V. Phone/Fax

Practice location:
  • Phone: 605-348-2556
  • Fax: 605-348-1526
Mailing address:
  • Phone: 605-348-2556
  • Fax: 605-348-1526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License NumberD1040
License Number StateSD

VIII. Authorized Official

Name: DR. JOSHUA WADE NEHRING
Title or Position: PERIODONTIST
Credential: DDS
Phone: 605-348-2556