Organization Active NPI

Le Mars Dental Center

  • General Practice Dentistry
  • Le Mars, IA
National Provider Identifier
1124710306
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LE MARS DENTAL CENTER
Practice address
1311 Hawkeye Ave SW
Le Mars, IA 51031-1866
Phone
(712) 546-5183
NPI assigned
May 24, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Authorized official

Name
Dr. Travis Matthew Van Roekel, DDSNPI 1043889546
Title
Owner/Dentist
Phone
(712) 546-5183

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1311 Hawkeye Ave SW
Le Mars, IA 51031-1866

Mailing address

1311 Hawkeye Ave SW
Le Mars, IA 51031-1866
Phone (712) 546-5183

National Provider Directory

National Provider Directory

Locations

1311 Hawkeye Ave SW
Le Mars, IA 51031
Phone (712) 546-5183

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684886400000",
    "number": "1124710306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 HAWKEYE AVE SW",
            "city": "LE MARS",
            "state": "IA",
            "postal_code": "510311866",
            "telephone_number": "712-546-5183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 HAWKEYE AVE SW",
            "city": "LE MARS",
            "state": "IA",
            "postal_code": "510311866",
            "telephone_number": "712-546-5183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LE MARS DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A",
        "authorized_official_last_name": "VAN ROEKEL",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "712-546-5183",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Le Mars, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.