Healthcare Provider Details

I. General information

NPI: 1093660037
Provider Name (Legal Business Name): JAYME LEE TUBANDT MPH, RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 03/04/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 W 22ND ST
SIOUX FALLS SD
57105-1305
US

IV. Provider business mailing address

2501 W 22ND ST
SIOUX FALLS SD
57105-1305
US

V. Phone/Fax

Practice location:
  • Phone: 605-333-6837
  • Fax:
Mailing address:
  • Phone: 605-333-6837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH1350
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: