NPIMap

Organization Active NPI

Bettendorf Dental PC

  • General Practice Dentistry
  • Bettendorf, IA
National Provider Identifier
1013044684
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
06583 Issued in IA
Legal business name
BETTENDORF DENTAL PC
Practice address
2515 Maplecrest Road
Bettendorf, IA 52722
Phone
(563) 332-1600
Fax
(563) 332-2219
NPI assigned
Feb 28, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Christine L Dahl, DDSNPI 1730345661
Title
President
Phone
(563) 332-1600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 06583 IA Primary

Addresses

Primary practice location

2515 Maplecrest Road
Bettendorf, IA 52722

Mailing address

2515 Maplecrest Road
Bettendorf, IA 52722
Phone (563) 332-1600

National Provider Directory

National Provider Directory

Locations

2515 Maplecrest Rd
Bettendorf, IA 52722
Phone (563) 332-1600

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013044684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 MAPLECREST ROAD",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "52722",
            "telephone_number": "563-332-1600",
            "fax_number": "563-332-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 MAPLECREST ROAD",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "52722",
            "telephone_number": "563-332-1600",
            "fax_number": "563-332-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETTENDORF DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAHL",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "563-332-1600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "06583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.