Provider Demographics
NPI:1902915812
Name:NORBERG, STEVEN ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ALAN
Last Name:NORBERG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5009 W 12TH ST
Mailing Address - Street 2:SUITE#3
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-3988
Mailing Address - Country:US
Mailing Address - Phone:605-335-3175
Mailing Address - Fax:605-335-3176
Practice Address - Street 1:5009 W 12TH ST
Practice Address - Street 2:SUITE#3
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-3988
Practice Address - Country:US
Practice Address - Phone:605-335-3175
Practice Address - Fax:605-335-3176
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDM5091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0936104Medicaid