Individual provider Active NPI

Stephen Matthhew Karbacka, D.D.S.

  • General Practice Dentistry
  • Ankeny, IA
National Provider Identifier
1023144102
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
08301 Issued in IA
Practice address
306 SW Walnut St
Ankeny, IA 50023-3042
Phone
(515) 964-0621
Fax
(515) 964-2408
NPI assigned
Feb 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 08301 IA Primary

Addresses

Primary practice location

306 SW Walnut St
Ankeny, IA 50023-3042

Mailing address

306 SW Walnut St
Ankeny, IA 50023-3042
Phone (515) 964-0621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150605000311 IA Order and Referring Only - DentistPractitioner - Dentist 6002137825

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08301IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ankeny Dental Center PC General Practice Past Accepting new patients
Jacqueline Smith DDS PC PastSince Dec 6, 2022 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023144102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 SW WALNUT ST",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500233042",
            "telephone_number": "515-964-0621",
            "fax_number": "515-964-2408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 SW WALNUT ST",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500233042",
            "telephone_number": "515-964-0621",
            "fax_number": "515-964-2408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARBACKA",
        "first_name": "STEPHEN",
        "middle_name": "MATTHHEW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ankeny, IA

Sources for this page

Verify at the official NPI Registry.