NPIMap

Organization Active NPI

Town Square Dental Care, PC

Doing business as Town Square Dental Care

  • Dental Clinic/Center
  • Oskaloosa, IA
National Provider Identifier
1073780417
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
08216 Issued in IA
Legal business name
TOWN SQUARE DENTAL CARE, PC
Doing business as
Town Square Dental Care
Practice address
107 High Ave E
Oskaloosa, IA 52577-2831
Phone
(641) 673-3008
NPI assigned
May 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Authorized official

Name
Dr. Eric Chad De Boef, D.D.S.NPI 1619058427
Title
President
Phone
(641) 673-3008

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
Dental Clinic/Center 261QD0000X 08216 IA Primary

Addresses

Primary practice location

107 High Ave E
Oskaloosa, IA 52577-2831

Mailing address

107 High Ave E
Oskaloosa, IA 52577-2831
Phone (641) 673-3008

Other identifiers 1

IdentifierTypeStateIssuer
1291526MedicaidIA

Other names 1

  • Town Square Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

107 High Ave E
Oskaloosa, IA 52577
Phone (641) 673-3008

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1073780417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 HIGH AVE E",
            "city": "OSKALOOSA",
            "state": "IA",
            "postal_code": "525772831",
            "telephone_number": "641-673-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 HIGH AVE E",
            "city": "OSKALOOSA",
            "state": "IA",
            "postal_code": "525772831",
            "telephone_number": "641-673-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN SQUARE DENTAL CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "DE BOEF",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "CHAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "641-673-3008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IA",
            "license": "08216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1291526",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Town Square Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oskaloosa, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.