NPIMap

Organization Active NPI

Sergeant Bluff Smiles

  • General Practice Dentistry
  • Sergeant Bluff, IA
National Provider Identifier
1053774562
Registry record updated Apr 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
08538 Issued in IA
Legal business name
SERGEANT BLUFF SMILES
Practice address
104 Port Neal Rd
Sergeant Bluff, IA 51054-8097
Phone
(712) 943-4746
NPI assigned
Apr 1, 2016
Last updated
Apr 1, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2016

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

Authorized official

Name
Dr. Laura GieseNPI 1760620397
Title
Dentist
Phone
(712) 943-4746

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 08538 IA Primary

Addresses

Primary practice location

104 Port Neal Rd
Sergeant Bluff, IA 51054-8097

Mailing address

104 Port Neal Rd
Sergeant Bluff, IA 51054-8097
Phone (712) 943-4746

National Provider Directory

National Provider Directory

Locations

104 Port Neal Rd
Sergeant Bluff, IA 51054
Phone (712) 943-4746

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1459468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459468800000",
    "number": "1053774562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 PORT NEAL RD",
            "city": "SERGEANT BLUFF",
            "state": "IA",
            "postal_code": "510548097",
            "telephone_number": "712-943-4746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 PORT NEAL RD",
            "city": "SERGEANT BLUFF",
            "state": "IA",
            "postal_code": "510548097",
            "telephone_number": "712-943-4746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERGEANT BLUFF SMILES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-01",
        "last_updated": "2016-04-01",
        "status": "A",
        "authorized_official_last_name": "GIESE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "712-943-4746",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sergeant Bluff, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; 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.