Individual provider Active NPI

Miranda Foster, DDS

  • General Practice Dentistry
  • Bettendorf, IA
National Provider Identifier
1043736473
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS-09844 Issued in IA
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

Updated by the provider on Jan 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171205000268 IL Order and Referring Only - DentistPractitioner - Dentist 6901163633

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS-09844IAMDGeneral Practice Dentistry
019.031326ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Applewhite Dental Iowa PC General Practice PastSince Jan 24, 2021 Accepting new patients
Bettendorf Dental PC General Practice PastSince Jan 24, 2021 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

Verify at the official NPI Registry.