NPIMap

Thomas J. Bauer, D.D.S.

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Iowa City, IA

NPI 1003909508 · NPPES record last updated Feb 20, 2013

Key facts

NPI
1003909508
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
License
30363 (IA)
Practice address
322 Dental Science S
Iowa City, IA 52242-1001
Phone
(319) 384-1139
Fax
(319) 384-1785
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6643-15WIMDDentist
30363IAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
York Orthodontics Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6643-15 WI
Student in an Organized Health Care Education/Training Program 390200000X 30363 IA Yes

Addresses

Primary practice location

322 Dental Science S
Iowa City, IA 52242-1001

Mailing address

322 Dental Science S
Iowa City, IA 52242-1001
Phone (319) 384-1139

Other providers in Iowa City, IA

All providers in Iowa City, IA · Student in an Organized Health Care Education/Training Program in Iowa

Sources for this page

Verify at the official NPI Registry.