Black Hills Pediatric Dentistry Surgery Center

LBN: Rushmore Ambulatory Surgery Center
Black Hills Pediatric Dentistry Surgery Center is an health care organization with primary practice located at 620 Sheridan Lake Rd Suite 104, Rapid City SD 57702-2406. The organization recently has only one registered license in Ambulatory Health Care Facilities / Ambulatory Surgical, which is considered as the primary health care specialty. Rushmore Ambulatory Surgery Center can be contacted via phone (605) 341-1314, or through Jobman, Kelli J via phone (605) 718-9224.

Contact Information

Primary practice address
620 Sheridan Lake Rd Suite 104 Rapid City SD 57702-2406
Fax: (605) 341-5757
Website:
Authorized official contact:
Name: Jobman, Kelli J Doctor of Dental Surgery (DDS)

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Ambulatory Surgical 261QA1903X

Profile Details

NPI number 1013968718
LBN Legal business name Rushmore Ambulatory Surgery Center
DBA Doing business as Black Hills Pediatric Dentistry Surgery Center
Authorized official Jobman, Kelli J Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date May 15th, 2006
Last updated Aug 9th, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013968718 NPPES
South Dakota MEDICAID 5490450
South Dakota Other 81022

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