Countryside Dental Care LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

COUNTRYSIDE DENTAL CARE LLC

Practice address

1903 Ep True Pkwy # S301
West Des Moines, IA 50265-7000

Phone

(515) 224-1618

NPI assigned

May 5, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Melanie Duncan

Title

Office Manager

Phone

(515) 224-1618

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bruce C Krook, D.D.S.

  • General Practice Dentistry
  • West Des Moines, IA
  • NPI 1114009123
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1273017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273017600000",
    "number": "1003134776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 EP TRUE PKWY # S301",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502657000",
            "telephone_number": "515-224-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 EP TRUE PKWY # S301",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502657000",
            "telephone_number": "515-224-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRYSIDE DENTAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-05",
        "last_updated": "2010-05-05",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "515-224-1618"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.