NPIMap

Organization Active NPI

State University of Iowa

Doing business as Hospital Dentistry Institute

  • Dentist
  • Iowa City, IA
National Provider Identifier
1114905387
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
STATE UNIVERSITY OF IOWA
Doing business as
Hospital Dentistry Institute
Practice address
200 Hawkins Drive
51300 Pomerantz Family Pavilion
Iowa City, IA 52242-1049
Phone
(319) 356-2743
Fax
(319) 353-6923
NPI assigned
Jan 6, 2006
Last updated
Feb 28, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
STATE UNIVERSITY OF IOWAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Authorized official

Name
Paulina Janczuk, BBA MPH
Title
Assistant Dean Financial Affairs
Phone
(319) 467-0735

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary
Prosthodontics 1223P0700X NU
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X NU

Addresses

Primary practice location

200 Hawkins Drive
51300 Pomerantz Family Pavilion
Iowa City, IA 52242-1049

Mailing address

200 Hawkins Drive
51300 Pomerantz Family Pavilion
Iowa City, IA 52242-1049
Phone (319) 356-2743

Other identifiers 2

IdentifierTypeStateIssuer
0177832MedicaidIA
33538OtherIAWELLMARK MAXILLOFACIAL SP

Other names 1

  • Hospital Dentistry Institute Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031107000060 IA Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 2,348 practitioners
37 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 36

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 36

National Provider Directory

National Provider Directory
Tax ID family
Univ of Ia Hosps Clins57 organizations share this tax ID, including this one
Part of
Univ of Ia Hosps Clins

Organizations with this tax ID in the same state 19

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 19

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 9

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": "1136505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740700800000",
    "number": "1114905387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DRIVE",
            "address_2": "51300 POMERANTZ FAMILY PAVILION",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421049",
            "telephone_number": "319-356-2743",
            "fax_number": "319-353-6923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DRIVE",
            "address_2": "51300 POMERANTZ FAMILY PAVILION",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421049",
            "telephone_number": "319-356-2743",
            "fax_number": "319-353-6923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE UNIVERSITY OF IOWA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE UNIVERSITY OF IOWA",
        "enumeration_date": "2006-01-06",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A",
        "authorized_official_last_name": "JANCZUK",
        "authorized_official_first_name": "PAULINA",
        "authorized_official_title_or_position": "ASSISTANT DEAN FINANCIAL AFFAIRS",
        "authorized_official_telephone_number": "319-467-0735",
        "authorized_official_credential": "BBA MPH"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0177832",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK MAXILLOFACIAL SP",
            "identifier": "33538",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hospital Dentistry Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.