Idema, Douglas E
Idema, Douglas E is an individual health care provider with primary practice located at 2521 S Western Ave , Sioux Falls SD 57105. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Idema, Douglas E can be contacted via phone (605) 336-1967.Contact Information
Primary practice address
2521 S Western Ave
Sioux Falls SD 57105
Phone: (605) 336-1967
Fax: (605) 731-1860
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | M266 | South Dakota |
Profile Details
| NPI number | 1285709394 |
|---|---|
| LBN Legal business name | Idema, Douglas E |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 22nd, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285709394 | NPPES |
| South Dakota | MEDICAID | 7800750 |
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