Provider Demographics
NPI:1932659539
Name:UMIKER, JOAN (DMD)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:UMIKER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 MARS ST
Mailing Address - Street 2:
Mailing Address - City:PIERRE
Mailing Address - State:SD
Mailing Address - Zip Code:57501-5743
Mailing Address - Country:US
Mailing Address - Phone:801-721-8476
Mailing Address - Fax:
Practice Address - Street 1:640 E SIOUX AVE
Practice Address - Street 2:
Practice Address - City:PIERRE
Practice Address - State:SD
Practice Address - Zip Code:57501-3300
Practice Address - Country:US
Practice Address - Phone:605-224-5355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-06
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDD12401223G0001X, 1223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health
Yes1223G0001XDental ProvidersDentistGeneral Practice