Cornerstone Dental of Iowa,LLC

Primary specialty

DentistTaxonomy code 122300000X

License

08491 Issued in IA

Legal business name

CORNERSTONE DENTAL OF IOWA,LLC

Practice address

201 N 3Rd Street
Unit F
Polk City, IA 50226

Phone

(515) 984-6001

NPI assigned

Feb 26, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Ryan Hussong, DDS

Title

Chairperson

Phone

(515) 984-6001

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cornerstone Dental Other name

Locations

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

{
    "created_epoch": "1267142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267142400000",
    "number": "1043532302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 170",
            "city": "POLK CITY",
            "state": "IA",
            "postal_code": "502260170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N 3RD STREET",
            "address_2": "UNIT F",
            "city": "POLK CITY",
            "state": "IA",
            "postal_code": "50226",
            "telephone_number": "515-984-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE DENTAL OF IOWA,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-26",
        "last_updated": "2010-02-26",
        "status": "A",
        "authorized_official_last_name": "HUSSONG",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CHAIRPERSON",
        "authorized_official_telephone_number": "515-984-6001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IA",
            "license": "08491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0080200",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerstone Dental",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Seth Bonifas
• Brenda Lee Carlson, APRN, ACNS-BC
• Centers for Long Term Care of Iowa
• City of Polk City
• Cornerstone Dental Group LLC
• Cornerstone Dental of Polk City LLC
• Cornerstone Dental Staffing LLC
• Kristin Marie Davis, ARNP
• Judith Detmering, R.N.
• Discovery Children'S Learning Center and Preschool Inc

• Dentist in Polk City, IA
• Providers in Polk City, IA by specialty
• Dentist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2010; 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.