NPIMap

Organization Active NPI

Bruce a D'Agostino DDS PC

  • General Practice Dentistry
  • Maquoketa, IA
National Provider Identifier
1083881270
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6471 Issued in IA
Legal business name
BRUCE A D'AGOSTINO DDS PC
Practice address
402 W Platt St
Maquoketa, IA 52060-2161
Phone
(563) 652-3811
Fax
(563) 652-3187
NPI assigned
May 15, 2008
Last updated
May 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Authorized official

Name
Dr. Bruce Anthony D'Agostino, DDSNPI 1063413839
Title
President
Phone
(563) 652-3811

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 Dentistry 1223G0001X 6471 IA Primary

Addresses

Primary practice location

402 W Platt St
Maquoketa, IA 52060-2161

Mailing address

402 W Platt St
Maquoketa, IA 52060-2161
Phone (563) 652-3811

Other identifiers 1

IdentifierTypeStateIssuer
1164376MedicaidLA

National Provider Directory

National Provider Directory

Locations

402 W Platt St
Maquoketa, IA 52060
Phone (563) 652-3811

Practitioners & affiliated clinicians

Practitioners 3

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": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1083881270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 W PLATT ST",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520602161",
            "telephone_number": "563-652-3811",
            "fax_number": "563-652-3187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W PLATT ST",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520602161",
            "telephone_number": "563-652-3811",
            "fax_number": "563-652-3187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE A D'AGOSTINO DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "D'AGOSTINO",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "563-652-3811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "6471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164376",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maquoketa, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.