NPIMap

Organization Active NPI

Douglas J Recker

  • General Practice Dentistry
  • Hiawatha, IA
National Provider Identifier
1043267883
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7455 Issued in IA
Legal business name
DOUGLAS J RECKER
Practice address
1475 Boyson Rd
Hiawatha, IA 52233-2339
Phone
(319) 393-4019
Fax
(319) 378-2924
NPI assigned
May 27, 2006
Organization subpart
Yes
Parent organization
DOUGLAS J RECKERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Dr. Douglas James Recker, DDSNPI 1306891049
Title
Owner Dentist
Phone
(319) 393-4019

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 7455 IA Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 7638 IA

Addresses

Primary practice location

1475 Boyson Rd
Hiawatha, IA 52233-2339

Mailing address

1475 Boyson Road
Hiawatha, IA 52233-2339
Phone (319) 393-4019

Other identifiers 3

IdentifierTypeStateIssuer
0200759OtherMEDICAID GROUP
0083212MedicaidIA
1123307MedicaidIA

Other names 1

  • Boyson Dental Former legal business name

National Provider Directory

National Provider Directory
Part of
Douglas J Recker

Locations

1475 Boyson Rd
Hiawatha, IA 52233
Phone (319) 373-4019

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1043267883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 BOYSON ROAD",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "522332339",
            "telephone_number": "319-393-4019",
            "fax_number": "319-378-2924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 BOYSON RD",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "522332339",
            "telephone_number": "319-393-4019",
            "fax_number": "319-378-2924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS J RECKER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DOUGLAS J RECKER",
        "enumeration_date": "2006-05-27",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "RECKER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "319-393-4019",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "7455",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "7638",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "0200759",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0083212",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1123307",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boyson Dental",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Hiawatha, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.