Individual provider Active NPI

Juliane Marie Herder Winters, DDS

  • Dentist
  • Des Moines, IA
National Provider Identifier
1114448388
Registry record updated Aug 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS-09428 Issued in IA
Practice address
1801 Hickman Rd.
Broadlawns Medical Center Dental Clinic
Des Moines, IA 50314
Phone
(507) 208-3792
NPI assigned
Jun 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS-09428 IA Primary

Addresses

Primary practice location

1801 Hickman Rd.
Broadlawns Medical Center Dental Clinic
Des Moines, IA 50314

Mailing address

1801 Hickman Road
Des Moines, IA 50314
Phone (515) 282-2421

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170807000582 IA Practitioner - Oral Surgery 1658642822 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS-09428IAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Broadlawns Medical Center CurrentSince Jul 15, 2017 Accepting new patients
Broadlawns Medical Center CurrentSince Jul 15, 2017 Accepting new patients

Locations

1801 Hickman Rd
Des Moines, IA 50314
Phone (515) 282-2200

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503360000000",
    "number": "1114448388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 HICKMAN ROAD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "50314",
            "telephone_number": "515-282-2421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 HICKMAN RD.",
            "address_2": "BROADLAWNS MEDICAL CENTER DENTAL CLINIC",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "50314",
            "telephone_number": "507-208-3792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINTERS",
        "first_name": "JULIANE",
        "middle_name": "MARIE HERDER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-28",
        "last_updated": "2017-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "DDS-09428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.