Northeast Iowa Dental Professional Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

NORTHEAST IOWA DENTAL PROFESSIONAL CORPORATION

Doing business as

Family Dentistry Associates of Monona

Practice address

101 Franklin
Monona, IA 52159

Phone

(563) 539-4651

Fax

(563) 539-4653

NPI assigned

Sep 6, 2006

Last updated

Dec 18, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

NORTHEAST IOWA DENTAL PROFESSIONAL CORPORATIONAs reported in NPPES

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

Authorized official

Name

Mrs. Judy Sue Kurth

Title

Office Manager

Phone

(563) 568-3983

Specialties & licenses 1

Addresses

Other names 1

• Family Dentistry Associates of Monona Doing business as

Part of

Northeast Iowa Dental Professional Corporation

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229558400000",
    "number": "1003919135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 965",
            "city": "MONONA",
            "state": "IA",
            "postal_code": "52159",
            "telephone_number": "563-539-4651",
            "fax_number": "563-539-4653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 FRANKLIN",
            "city": "MONONA",
            "state": "IA",
            "postal_code": "52159",
            "telephone_number": "563-539-4651",
            "fax_number": "563-539-4653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST IOWA DENTAL PROFESSIONAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHEAST IOWA DENTAL PROFESSIONAL CORPORATION",
        "enumeration_date": "2006-09-06",
        "last_updated": "2008-12-18",
        "status": "A",
        "authorized_official_last_name": "KURTH",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "563-568-3983",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Dentistry Associates of Monona",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark Gary Fohey, DDS
• Todd Eric Hanson, DC
• Robin R Laube
• M-F-L Ambulance Service, Inc.
• MFL Marmac CSD
• PPRC, LLC (Garden View Place)
• Pamela Sue Schweitzer, DDS
• Lori Rae Vlazny, ARNP
• Darcy Denise Weller, RN
• Jessica Marie Wilke, DDS

• General Practice Dentistry in Monona, IA
• Providers in Monona, 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 Dec 18, 2008; 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.