NPI 1124468590 · live from the CMS NPI Registry
Custom Endodontics, PC
Dentist, Endodontics in Bismarck, ND. National Provider Identifier 1124468590, active.
NPI record
| NPI | 1124468590 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Endodontics 1223E0200X |
| Practice location | 521 E Main Ave, Suite 100, Bismarck, ND 58501 |
| Practice phone | 701-255-2523 |
| Mailing address | 521 E Main Ave Ste 100, Bismarck, ND 58501 |
| Enumerated | July 1, 2013 |
| Last updated | October 7, 2026 |
| Authorized official | Michaela Muniz, Vp, Payor Relations |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Endodontics primary | 1223E0200X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.