Active NPI
John Campbell
- Dentist
- Des Moines, IA
National Provider Identifier
1073993564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DDS-09187
- Practice address
- 4001 6TH Ave
Des Moines, IA 50313-3430 - Phone
- (515) 288-1343
- NPI assigned
- Jun 1, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DDS-09187 | IA | Primary |
Addresses
Primary practice location
4001 6TH Ave
Des Moines, IA 50313-3430
Mailing address
4001 6TH Ave
Des Moines, IA 50313-3430
Phone (515) 288-1343
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS-09187 | IA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433116800000",
"number": "1073993564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4001 6TH AVE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503133430",
"telephone_number": "515-288-1343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4001 6TH AVE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503133430",
"telephone_number": "515-288-1343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "JOHN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-01",
"last_updated": "2015-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IA",
"license": "DDS-09187",
"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 Jun 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.