Active NPI
Thiago Soares Porto, DDS, MSC, PHD
- General Practice Dentistry
- Iowa City, IA
National Provider Identifier
1093283129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- FAC-40210
- Practice address
- 801 Newton Rd
Iowa City, IA 52242-1001 - Phone
- (319) 335-7440
- Fax
- (319) 335-7451
- NPI assigned
- Nov 7, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | FAC-40210 | IA | Primary |
| Dentist | 122300000X | 71.000256 | OH |
Addresses
Primary practice location
801 Newton Rd
Iowa City, IA 52242-1001
Mailing address
322 Dental Science BLDG S
Iowa City, IA 52242-1001
Phone (193) 335-7440
Other practice location 1
2124 Cornell Rd
Department of Comprehensive Care
Cleveland, OH 44106
Phone (216) 368-2486
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71.000256 | OH | MD | Dentist |
| FAC-40210 | IA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658275200000",
"number": "1093283129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "322 DENTAL SCIENCE BLDG S",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421001",
"telephone_number": "193-335-7440",
"fax_number": "319-335-7451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 NEWTON RD",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421001",
"telephone_number": "319-335-7440",
"fax_number": "319-335-7451"
}
],
"practiceLocations": [
{
"address_1": "2124 Cornell Rd",
"address_2": "Department of Comprehensive Care",
"address_purpose": "LOCATION",
"city": "Cleveland",
"state": "OH",
"postal_code": "44106",
"country_code": "US",
"telephone_number": "216-368-2486",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PORTO",
"first_name": "THIAGO",
"middle_name": "SOARES",
"credential": "DDS, MSC, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-07",
"last_updated": "2022-07-20",
"certification_date": "2022-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IA",
"license": "FAC-40210",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "71.000256",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Iowa City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.