NPIMap

Organization Active NPI

Restoration Dental, P.C.

  • Dental Clinic/Center
  • West Des Moines, IA
National Provider Identifier
1205003506
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
07847 Issued in IA
Legal business name
RESTORATION DENTAL, P.C.
Practice address
5465 Mills Civic Pkwy
Suite 260
West Des Moines, IA 50266-5318
Phone
(515) 440-3393
Fax
(515) 440-1159
NPI assigned
May 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Authorized official

Name
Dr. Jay Jerald Jensen, D.D.S.
Title
Owner
Phone
(515) 440-3393

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 07847 IA Primary

Addresses

Primary practice location

5465 Mills Civic Pkwy
Suite 260
West Des Moines, IA 50266-5318

Mailing address

5465 Mills Civic Pkwy
Suite 260
West Des Moines, IA 50266-5318
Phone (515) 440-3393

National Provider Directory

National Provider Directory

Locations

5465 Mills Civic Pkwy
Ste 260
West Des Moines, IA 50266
Phone (515) 440-3393

NPI Registry JSON

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1205003506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5465 MILLS CIVIC PKWY",
            "address_2": "SUITE 260",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665318",
            "telephone_number": "515-440-3393",
            "fax_number": "515-440-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5465 MILLS CIVIC PKWY",
            "address_2": "SUITE 260",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665318",
            "telephone_number": "515-440-3393",
            "fax_number": "515-440-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATION DENTAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "JERALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-440-3393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IA",
            "license": "07847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.