Joseph Richard Deatherage
DMD, MD | Oral and Maxillofacial Surgeon | 34+ years Exp
1730 Burnt Boat Dr Ste 300, Bismarck
North Dakota, 58503-0886
701-258-7220 701-222-2329
Maps & DirectionsJoseph Richard Deatherage is a Bismarck, North Dakota based Oral and Maxillofacial Surgeon with
34 years of experience in
Oral and Maxillofacial Surgery. He completed his graduation from
University Of Texas Medical School At San Antonio in 1992. He accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Joseph Richard Deatherage is
2069 for Oral and Maxillofacial Surgery in North Dakota. His current practice location is
1730 Burnt Boat Dr Ste 300, Bismarck. Patients can reach him at
701-258-7220.
Joseph Richard Deatherage deals with the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Complete Profile:
Joseph Richard Deatherage speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Joseph Richard Deatherage |
| Specialization: | Oral and Maxillofacial Surgeon |
| Gender: | Male |
| Credentials: | DMD, MD |
| Experience: | 34+ years |
| Medical School Attended: | University Of Texas Medical School At San Antonio |
| Graduation Year: | 1992 |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 1730 Burnt Boat Dr Ste 300, Bismarck,
North Dakota, 58503-0886 |
| Phone: | 701-258-7220 |
| Fax: | 701-222-2329 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 5395764278 |
| Enrollment ID: | I20100511001065 |
| NPI Number: | 1003859117 |
| NPI Enumeration Date: | 14 Jun, 2006 |
| NPI Last Update On: | 01 May, 2019 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Joseph Richard Deatherage are as mentioned below.
| License Number | Specialization | State | Status | |
| 2069 | Oral and Maxillofacial Surgery | North Dakota | Primary | |
Group Practice:
Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name
with which Joseph Richard Deatherage is associated with along with the number of members in that group.
| Organization Name (Group PAC ID) | Members |
| Face And Jaw Surgeons Pc (1153311881) | 6 |
Other Medical Identifiers:
Other legacy medical identifiers associated with Joseph Richard Deatherage such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 2069 | Other | North Dakota | DENTAL LICENSE |
| 41524 | Medicaid | North Dakota | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 1730 Burnt Boat Dr Ste 300,
Bismarck, North Dakota |
| Zip: | 58503-0886 |
| Phone Number: | 701-258-7220 |
| Fax Number: | 701-222-2329 |
Patients can reach Joseph Richard Deatherage at
1730 Burnt Boat Dr Ste 300, Bismarck, North Dakota or can
call to book an appointment on 701-258-7220.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.