Epworth Family Dentistry PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

06878 Issued in IA

Legal business name

EPWORTH FAMILY DENTISTRY PC

Practice address

208 N Center Ave
Epworth, IA 52045-7741

Phone

(563) 876-3396

Fax

(563) 876-3396

NPI assigned

Apr 8, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Kim David Kissell, DDS

Title

President

Phone

(563) 876-3396

Specialties & licenses 1

Addresses

Tax ID family

Epworth Family Dentistry PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Epworth Family Dentistry, P.C.

  • General Practice Dentistry
  • Epworth, IA
  • NPI 1164817888
  NPD tax ID

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270684800000",
    "number": "1124344742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 N CENTER AVE",
            "city": "EPWORTH",
            "state": "IA",
            "postal_code": "520457741",
            "telephone_number": "563-876-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 N CENTER AVE",
            "city": "EPWORTH",
            "state": "IA",
            "postal_code": "520457741",
            "telephone_number": "563-876-3396",
            "fax_number": "563-876-3396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPWORTH FAMILY DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-08",
        "last_updated": "2010-04-08",
        "status": "A",
        "authorized_official_last_name": "KISSELL",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "563-876-3396",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IA",
            "license": "06878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy May Blum, RN, IBCLC
• Epworth Community Firemen
• Epworth Family Chiropractic, P.C.
• Epworth Family Dentistry, P.C.
• Mary Jo Kelchen, D.C.
• Kim David Kissell, DDS
• Leslie J Kremer, PT
• Ryan T Oetken, D.D.S.

• Dental Clinic/Center in Epworth, IA
• Providers in Epworth, IA by specialty
• Dental Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; 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.