NPIMap

Organization Active NPI

Eastern Iowa Periodontics, PC

  • Periodontics
  • Coralville, IA
National Provider Identifier
1083947667
Registry record updated Sep 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
08614 Issued in IA
Legal business name
EASTERN IOWA PERIODONTICS, PC
Practice address
501 12TH Ave
Suite 202
Coralville, IA 52241-1774
Phone
(319) 351-5439
Fax
(319) 354-0491
NPI assigned
Sep 14, 2009
Last updated
Sep 14, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2009

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

Authorized official

Name
Dr. Adrienne S Gunstream, DDS, MSNPI 1952500365
Title
Periodontist
Phone
(319) 351-5439

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
Periodontics 1223P0300X 08614 IA Primary

Addresses

Primary practice location

501 12TH Ave
Suite 202
Coralville, IA 52241-1774

Mailing address

501 12TH Ave
Suite 202
Coralville, IA 52241-1774
Phone (319) 351-5439

National Provider Directory

National Provider Directory

Locations

501 12th Ave
Ste 202
Coralville, IA 52241
Phone (319) 351-5439

Practitioners & affiliated clinicians

Practitioners 5

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": "1252886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252886400000",
    "number": "1083947667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 12TH AVE",
            "address_2": "SUITE 202",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522411774",
            "telephone_number": "319-351-5439",
            "fax_number": "319-354-0491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 12TH AVE",
            "address_2": "SUITE 202",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522411774",
            "telephone_number": "319-351-5439",
            "fax_number": "319-354-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN IOWA PERIODONTICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-14",
        "last_updated": "2009-09-14",
        "status": "A",
        "authorized_official_last_name": "GUNSTREAM",
        "authorized_official_first_name": "ADRIENNE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PERIODONTIST",
        "authorized_official_telephone_number": "319-351-5439",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IA",
            "license": "08614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coralville, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2009; 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.