# DERIK HOERNER, DDS, PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Bismarck Advanced Dental and Implants, Bismarck Advanced Dental and Implants
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043321334
- **Authorized official:** DR. DERIK HOERNER D.D.S (DENTIST)
- **Authorized official phone:** (701) 955-5111

## Contact information

- **Practice address:** 1004 S. 7TH STREET, BISMARCK, ND 58504-6531
- **Practice address phone:** (701) 390-1920
- **Practice address fax:** (701) 255-4055
- **Mailing address:** 1004 S. 7TH STREET, BISMARCK, ND 58504-6531
- **Mailing address phone:** (701) 390-1920
- **Mailing address fax:** (701) 255-4055

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2057 | ND | Yes |
| 1223G0001X | General Practice Dentistry | 1387 | ND | — |
| 1223G0001X | General Practice Dentistry | 1427 | ND | — |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 06/08/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1387 | STATE DENTAL \# | ND |
| 01 | — | 1427 | STATE DENTAL LICENSE \# | ND |
| 01 | — | 2030 | NDBOE NUMBER | ND |
| 01 | — | 2057 | NDBOE NUMBER | ND |
| 05 | — | 40424 | — | ND |
| 05 | — | 40642 | — | ND |
| 05 | — | 40644 | — | ND |
| 05 | — | 41463 | — | ND |
| 05 | — | 41498 | — | ND |