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SCOTT D VAN DAM DDS, MD
NPI 1407836992
Oral & Maxillofacial Surgery in Rapid City, SD

Active since January 19, 2006Opted out of Medicare · through Mar 22, 2028
3415 5TH ST, RAPID CITY, SD 57701(605) 348-6818 Get Directions Write a Review

NPPES record last updated: November 28, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Scott D Van Dam Dds, Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SCOTT D VAN DAM DDS, MD (NPI 1407836992) is an individual oral & maxillofacial surgery provider in Rapid City, South Dakota, licensed in South Dakota (7080) and active in the NPI registry since January 2006. He has opted out of Medicare through March 22, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1407836992
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameSCOTT D VAN DAMCredential: DDS, MD
Location Address3415 5TH STRapid City, SD 57701-7365
Mailing Address3415 5th StRapid City, SD 57701-7365 · (605) 348-6818
Phone(605) 348-6818
Sole ProprietorNo
Enumeration DateJanuary 19, 2006
Last NPPES UpdateNovember 28, 2007
✔ NPI 1407836992 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in SD · 7080
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
3415 5TH ST, Rapid City, SD 57701
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Other Identifiers 3

Medicaid8000530SD
Medicare PINS101817SD
Medicare UPINU93675

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Scott D Van Dam Dds, Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 22, 2018 through March 22, 2028.

Opt-Out Effective DateMarch 22, 2018
Opt-Out In Effect ThroughMarch 22, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BLACK HILLS ORAL & MAXILLOFACIAL SURGERY PC
Dentist (Oral and Maxillofacial Pathology)
3415 5TH ST
RAPID CITY, SD 57701
Meade County (605) 348-6818
DR. ISAAC JOHN MORGAN DMD
Dentist (Oral and Maxillofacial Surgery)
3415 5TH ST
RAPID CITY, SD 57701
Meade County (605) 348-6818
DR. CODY CHRISTENSEN D.D.S.
Dentist (Oral and Maxillofacial Surgery)
3415 5TH ST
RAPID CITY, SD 57701
Meade County (605) 348-6818
DR. ROGER CAVE WILSON DDS, MS
Dentist (Oral and Maxillofacial Pathology)
3415 5TH ST
RAPID CITY, SD 57701
Meade County (605) 348-6818
DR. JAY ALAN CROSSLAND DDS
Dentist (Oral and Maxillofacial Surgery)
3415 5TH ST
RAPID CITY, SD 57701
Meade County (605) 348-6818
DR. BRIAN R RICHMAN DDS
Student in an Organized Health Care Education/Training Program
3415 5TH ST
RAPID CITY, SD 57701
Meade County (605) 348-6818

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 Scott Van Dam's NPI number?

The NPI number for Scott Van Dam is 1407836992. It was assigned to this individual provider in the NPPES registry on January 19, 2006.

Where is Scott Van Dam located?

Scott Van Dam practices at 3415 5th St, Rapid City, SD 57701. The listed phone number is (605) 348-6818.

What is Scott Van Dam's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Scott Van Dam enrolled in Medicare?

No. Scott Van Dam has opted out of Medicare through March 22, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Scott Van Dam was last updated on November 28, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.