Jessica Sanborn

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS-09825 Issued in IA

Practice address

8078 Douglas Ave
Urbandale, IA 50322-2450

Phone

(515) 276-7800

NPI assigned

Jun 16, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Steffany L Mohan DDS PC

  • Durable Medical Equipment & Medical Supplies
  • Urbandale, IA
  • NPI 1487381299
  NPD
• Family First Dental Associates of Wausa, P.C.

  • General Practice Dentistry
  • Creighton, NE
  • NPI 1073789756
  NPD (past)

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1104207067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8078 DOUGLAS AVE",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503222450",
            "telephone_number": "515-276-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8078 DOUGLAS AVE",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503222450",
            "telephone_number": "515-276-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANBORN",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-16",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "7231",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "DDS-09825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Rundle
• Erin Elizabeth Ryan, PA-C
• Sage Counseling and Wellness, LLC
• Gary Robert Sager, ED.D.
• Salt and Light Equity LLC
• Emily Adriane Sanders, PSY.D.
• Danielle Marie Sanger, PHARMD
• Sarah Anthoney, PH.D., PLLC
• Amelia Satre
• Saxton & Saxton Counseling

• General Practice Dentistry in Urbandale, IA
• Providers in Urbandale, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.