Individual provider Active NPI

Robert Charles Dahlberg, DDS

  • General Practice Dentistry
  • Des Moines, IA
National Provider Identifier
1063582898
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6967 Issued in IA
Practice address
300 E Locust St
#310
Des Moines, IA 50309-1865
Phone
(515) 282-0447
Fax
(515) 282-5964
NPI assigned
Nov 9, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6967 IA Primary

Addresses

Primary practice location

300 E Locust St
#310
Des Moines, IA 50309-1865

Mailing address

300 E Locust St
#310
Des Moines, IA 50309-1865
Phone (515) 282-0447

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6967IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Centric,P.C. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063582898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E LOCUST ST",
            "address_2": "#310",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091865",
            "telephone_number": "515-282-0447",
            "fax_number": "515-282-5964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E LOCUST ST",
            "address_2": "#310",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091865",
            "telephone_number": "515-282-0447",
            "fax_number": "515-282-5964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLBERG",
        "first_name": "ROBERT",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "6967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.