Individual provider Active NPI

Kudzai Chikwava, DDS

  • General Practice Dentistry
  • Council Bluffs, IA
National Provider Identifier
1093943391
Registry record updated Sep 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
08638 Issued in IA
Practice address
300 W Broadway
Suite 6
Council Bluffs, IA 51503-9078
Phone
(712) 256-6572
NPI assigned
Jun 24, 2009
Last updated
Sep 10, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 08638 IA Primary

Addresses

Primary practice location

300 W Broadway
Suite 6
Council Bluffs, IA 51503-9078

Mailing address

15011 Bemis St
Omaha, NE 68154-1843
Phone (919) 423-6386

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

LicenseStateTypeSpecialty
08638IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kudzai Chikwawa DDS LLC Aspire Dentistry General Practice CurrentSince Oct 13, 2024 Accepting new patients
Kudzai Chikwava DDS LLC Asdent Dentistry CurrentSince Feb 23, 2025 Accepting new patients

Locations

1625 McCallie Ave
Chattanooga, TN 37404
Phone (423) 521-3550

4727 Brainerd Rd
Chattanooga, TN 37411
Phone (423) 622-4869

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347235200000",
    "number": "1093943391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15011 BEMIS ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681541843",
            "telephone_number": "919-423-6386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W BROADWAY",
            "address_2": "SUITE 6",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515039078",
            "telephone_number": "712-256-6572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIKWAVA",
        "first_name": "KUDZAI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-24",
        "last_updated": "2012-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; 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.