Healthcare Provider Details

I. General information

NPI: 1184843450
Provider Name (Legal Business Name): DR. SCOTT VELGERSDYK, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 S MINNESOTA AVE
SIOUX FALLS SD
57105-3748
US

IV. Provider business mailing address

2200 S MINNESOTA AVE
SIOUX FALLS SD
57105-3748
US

V. Phone/Fax

Practice location:
  • Phone: 605-334-4121
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License NumberM739
License Number StateSD

VIII. Authorized Official

Name: SCOTT VELGERSDYK
Title or Position: PRESIDENT
Credential: DDS
Phone: 605-371-4521