JOSEPH RICHARD DEATHERAGE DMD, MD
NPI 1003859117
Dentist - Oral and Maxillofacial Surgery in Bismarck, ND
About Joseph Richard Deatherage Dmd, Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JOSEPH RICHARD DEATHERAGE DMD, MD (NPI 1003859117) is an individual oral and maxillofacial surgery provider in Bismarck, North Dakota, licensed in North Dakota (2069) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Bismarck, and is a graduate of University Of Texas Medical School At San Antonio (1992).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Joseph Richard Deatherage Dmd, Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Joseph Deatherage reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Bismarck, ND 58501
- Reassigned Medicare billing, North Dakota enrollment
- 14 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 58503 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Joseph Deatherage's NPI number?
The NPI number for Joseph Deatherage is 1003859117. It was assigned to this individual provider in the NPPES registry on June 14, 2006.
Where is Joseph Deatherage located?
Joseph Deatherage practices at 1730 Burnt Boat Dr Ste 300, Bismarck, ND 58503. The listed phone number is (701) 258-7220.
What is Joseph Deatherage's specialty?
The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.
Is Joseph Deatherage enrolled in Medicare?
Yes. Joseph Deatherage is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Joseph Deatherage's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Joseph Deatherage reassigns Medicare benefits to Face And Jaw Surgeons PC (Bismarck, ND). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Joseph Deatherage's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Joseph Deatherage accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of North Dakota, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 2 other insurers list Joseph Deatherage as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Joseph Deatherage was last updated on May 1, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Joseph Richard Deatherage, DMD, MD · NPI 1003859117
Oral and Maxillofacial Surgery provider in Bismarck, North Dakota. Individual provider, active in the CMS NPPES registry since June 14, 2006.
## Identity
- **NPI:** 1003859117 (Entity type: Individual)
- **Enumerated:** June 14, 2006
- **Primary specialty:** Dentist - Oral and Maxillofacial Surgery · taxonomy 1223S0112X
- **State license:** 2069 (North Dakota)
- **Sole proprietor:** No
## Practice location
- **Address:** 1730 BURNT BOAT DR STE 300, Bismarck, ND 58503-0886
- **Phone:** (701) 258-7220 · **Fax:** (701) 222-2329
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Face And Jaw Surgeons PC (NPI 1184667305, Bismarck, ND), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Texas Medical School At San Antonio, class of 1992
## Record status
- **NPPES last updated:** May 1, 2019
- **Other identifiers:** Medicaid 41524 (ND); Other 2069 (ND)
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Source: [NPI Profile](https://npiprofile.com/npi/1003859117) · Data from the CMS NPPES public registry.