Active NPI
Miranda Foster, DDS
- General Practice Dentistry
- Bettendorf, IA
National Provider Identifier
1043736473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DDS-09844
- Practice address
- 2515 Maplecrest Rd
Bettendorf, IA 52722-2798 - Phone
- (563) 332-1600
- NPI assigned
- Aug 17, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DDS-09844 | IA | Primary |
| General Practice Dentistry | 1223G0001X | 019.031326 | IL |
Addresses
Primary practice location
2515 Maplecrest Rd
Bettendorf, IA 52722-2798
Mailing address
2515 Maplecrest Rd
Bettendorf, IA 52722-2798
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171205000268 | IL | Order and Referring Only - Dentist | 6901163633 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS-09844 | IA | MD | General Practice Dentistry |
| 019.031326 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Applewhite Dental Iowa PC | General Practice | Past | Accepting new patients |
| Bettendorf Dental PC | General Practice | Past | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611100800000",
"number": "1043736473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2515 MAPLECREST RD",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527222798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2515 MAPLECREST RD",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527222798",
"telephone_number": "563-332-1600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOSTER",
"first_name": "MIRANDA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-17",
"last_updated": "2021-01-20",
"certification_date": "2021-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IA",
"license": "DDS-09844",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019.031326",
"primary": false
}
],
"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 Jan 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.