Individual provider Active NPI

Kaaren Giselle Vargas, DDS PHD

  • Pediatric Dentistry
  • North Liberty, IA
National Provider Identifier
1063516060
Registry record updated Jan 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
08554 Issued in IA
Practice address
1730 Lininger LN
North Liberty, IA 52317-2322
Phone
(319) 665-2573
Fax
(866) 205-1876
NPI assigned
Sep 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 08554 IA Primary

Addresses

Primary practice location

1730 Lininger LN
North Liberty, IA 52317-2322

Mailing address

1730 Lininger LN
North Liberty, IA 52317-2316
Phone (319) 665-2573

Other identifiers 1

IdentifierTypeStateIssuer
1184358MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
08554IAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Kids Pediatric Dentistry, Inc Pediatric Dentistry CurrentSince Jan 21, 2024 Accepting new patients

Locations

100 6th Ave
Marion, IA 52302
Phone (319) 449-6789

Organizations & group practices 1

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": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294704000000",
    "number": "1063516060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 LININGER LN",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523172316",
            "telephone_number": "319-665-2573",
            "fax_number": "866-205-1876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 LININGER LN",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523172322",
            "telephone_number": "319-665-2573",
            "fax_number": "866-205-1876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "KAAREN",
        "middle_name": "GISELLE",
        "name_prefix": "Dr.",
        "credential": "DDS PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-11",
        "last_updated": "2011-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IA",
            "license": "08554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184358",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Liberty, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.